A Case Study Of Right-Wing Distortions Of Health Care Reform
by Sandi Behrns
The Association of American Medical Colleges released a report Thursday detailing an expected shortage of physicians in the US. In actuality, we are already struggling with a critical shortage of doctors, but as the study notes, the shortage will grow during the years that the Affordable Care Act is implemented.
Between now and 2015, the year after health care reforms are scheduled to take effect, the shortage of doctors across all specialties will quadruple. While previous projections showed a baseline shortage of 39,600 doctors in 2015, current estimates bring that number closer to 63,000, with a worsening of shortages through 2025.
That is alarming, but what is the cause? If we are to believe the right-wing blog Hot Air, it is because “Obamacare” will make medicine, especially critical specialties, less attractive:
With education becoming more and more expensive, physicians need to recoup their investment in it from plying their trade. Unfortunately, government reimbursement schedules will force payments down through the entire industry, making specializations in areas that have Medicare or Medicaid implications much less attractive.
In fact, the study says nothing of the sort. Hot Air even uses this very quote from a Reuters story on the study:
The U.S. healthcare reform law will worsen a shortage of physicians as millions of newly insured patients seek care, the Association of American Medical Colleges said on Thursday.
From the Reuters story, and from the AAMC study itself, it becomes clear that the problem is not centered in some disincentive to enter medicine, but rather that “32 million Americans [will] acquire health care coverage.” This refers, it must be noted, to Americans who are not currently clogging up your doctor’s waiting room, because they don’t have coverage.
Thing is, the shortage was coming, with or without the ACA, because an additional 36 million people will be entering Medicare.
With the U.S. Census Bureau projecting a 36 percent growth in the number of Americans over age 65, and nearly one-third of all physicians expected to retire in the next decade, the need for timely access to high-quality care will be greater than ever.
So, although an influx of newly-insured Americans will compound the problem, the greatest contributor to the anticipated shortfall of doctors is the aging Boomer population. It is certainly not, as Hot Air suggests, that people are being scared off from medicine. In fact, as noted by the AAMC, “The number of medical school students continues to increase, adding 7,000 graduates every year over the next decade.” It simply is not quite enough to tackle the scope of the problem.
Not only is the Hot Air piece dishonest, it is destructive. It has already today been passed around Twitter and the comments sections of numerous right-wing sites. Those already inclined to do so take the story at face value – and for them it becomes fact. The truth? That’s not important. The narrative that the health care bill is going to destroy America and must be repealed is too critical to let pesky things like facts get in the way.
Beyond that, it must be asked: if the GOP were to repeal ACA and replace it with something that, in some as yet undefined way, also expands coverage to more people – would we not still have the same problem? Are these people suggesting that more people having access to health care coverage is a bad thing? How about instead of spreading baseless lies, we actually try to address the unavoidable coming shortage of doctors? Thing is, it’ll take government action to do that:
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- Medicare’s support for physician training has been frozen since 1997. Unless the number of residency training positions expands at the nation’s teaching hospitals, the United States will face a declining number of physicians per capita just as the baby boomers swell the Medicare rolls.
- Congress must lift the freeze on Medicare-supported residency positions. Because all physicians must complete three or more years of residency training after they receive an M.D. degree, Medicare must continue paying for its share of training costs by supporting at least a 15 percent increase in GME positions, allowing teaching hospitals to prepare another 4,000 physicians a year to meet the needs of 2020 and beyond.
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