Tuesday, January 4th, 2011 - 14:53
Tuesday, January 4, 2011 - 13:23
As more people gain access to health coverage, it's crucial to keep an eye on efforts to expand the primary care workforce.
Over the weekend, the San Francisco Chronicle published an illumninating story about the looming shortage of primary care physicians and even specialists in many rural areas in California. While the state's population has grown, its large proportion of baby-boomer doctors are on the verge of retirement with an inadequate supply of younger doctors to take their place.
This shortage, which is a trend across the country, will only get worse as millions of new individuals gain coverage under health reform, which attempts to place a greater emphasis on primary care to drive down costs. The health reform law tries to establish more incentives to increase the number of primary care doctors overall, and to steer these doctors into underserved areas through scholarships and loan assistance programs.
However, the entry of millions of new customers into the health insurance system will ramp up in 2014, long before many of these programs have a chance to begin working against the status quo. The implementers of health reform will need to closely watch the primary care physician and nursing shortage in 2014 and the few years beyond to determine what might be done in the interim to increase access to primary care. Otherwise, many of those who gain insurance coverage under health reform may have a hard time actually getting themselves in front of doctors.
And, those in Congress who wish to protect health reform will need to keep a close watch on the Prevention and Public Health Fund. This is the fund that houses all of the grants and other programs in health reform that address the primary care shortage. As we wrote on this blog in early December, many Republicans wanted to target part of this fund to pay for the next round of the Medicare "doc fix." While the deal that was eventually agreed upon avoided touching this fund, it will likely remain a target for those who want to dismantle health reform through the withholding of funding.