Doctor Shortage
The new federal health-care law has raised the stakes for hospitals and schools already scrambling to train more doctors.
Experts warn there won’t be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges.
That shortfall is predicted despite a push by teaching hospitals and medical schools to boost the number of U.S. doctors, which now totals about 954,000.
The greatest demand will be for primary-care physicians. These general practitioners, internists, family physicians and pediatricians will have a larger role under the new law, coordinating care for each patient.
The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007.
Okay, so we’ve just passed a law that adds roughly 30 million people to the health insurance rolls and we were already facing a doctor shortage. Any guess what might happen to healthcare costs? Hmmm, let me think, this is a hard one. Increase demand for a service where shortages already exist……you know I’m thinking the price might go up. The health care reform had some minor inducements for people who choose to become medical professionals but it isn’t enough to make a difference. Prices are about to start rising even faster than they did before “reform”.
The problem is not just on the supply side. As long as we have a third party payment system where the individual can demand more care without regard to cost, demand for services will rise. That is the basic flaw in the system and the new law did nothing to address it.
So what will the government do when insurance companies try to raise premiums to cover the new costs? The only option will be to squeeze the insurance companies and try to make them pay regardless of whether they turn a profit. In fact, there is already movement in that direction. Massachussetts has just refused rate hikes for non profit health insurance companies and the providers are suing. If MA will deny a rate hike for a non profit insurer, what are the odds that they’ll approve one for a for profit entity? About zero would be my guess.
And what happens if the companies can’t make a profit? Well, I live in Florida where we’ve already done a trial run on this type of system except it is for homeowner’s insurance. After hurricane Andrew back in 1992 the insurers tried to raise rates but the state kept denying their requests. The result? I get all my homeowner’s coverage from the state. I know you must be shocked by that outcome but it is reality.
And the new health care reform bill doesn’t have a mechanism for denying rate hikes - yet.
Public outrage over double-digit rate hikes for health insurance may have helped push President Obama’s healthcare overhaul across the finish line, but the new law does not give regulators the power to block similar increases in the future.
And now, with some major companies already moving to boost premiums and others poised to follow suit, millions of Americans may feel an unexpected jolt in the pocketbook.
Although Democrats promised greater consumer protection, the overhaul does not give the federal government broad regulatory power to prevent increases.
Many state governments — which traditionally had responsibility for regulating insurance companies — also do not have such authority. And several that do are now being sued by insurance companies.
“It is a very big loophole in health reform,” Sen. Dianne Feinstein (D-Calif.) said. Feinstein and Rep. Jan Schakowsky (D-Ill.) are pushing legislation to expand federal and state authority to prevent insurance companies from boosting rates excessively.
At least in the short term, regulators will be able to do little more than require insurers to publicly explain why they want to raise rates. Consumer advocates think that will not be an effective deterrent against premium increases such as the 39% hike that Anthem Blue Cross sent some California customers last year.
The problem is not that the government can’t deny rate hike requests though. Thinking about it that way ignores the real problem. When you tell people they can have unlimited services for a flat fee, they avail themselves of it to the maximum degree. The insurance companies are just caught in the middle as the group tasked with paying the bills. And after the government eliminates all their profits and they leave the health insurance business, some government employee will have the pleasure of being the bad guy for denying services that people want.
We do need healthcare reform in this country but what we just got is going to make the problem worse. Brace yourself because healthcare will be a part of the political debate for decades to come.
- April 13th
