ALLEN: Looming health-care crisis
Van Allen
Friday, September 5, 2008
COMMENTARY:
The U.S. Census Bureau this week reported the number of Americans without health insurance fell last year to 45.7 million, down from the previous estimate of 47 million. Good news for sure, but of little comfort to those families and individuals still without coverage.
Despite the positive development, access to health insurance will remain a major focus of the presidential campaigns, and with good reason. There is a looming health-care crisis in this nation, and candidates Barack Obama and John McCain offer different solutions to lower insurance costs and extend coverage universally.
The rhetoric sounds good on the stump, but it ignores the fact that universal health-care coverage won't do the nation any good if there aren't enough doctors to provide needed health-care services.
There is already a dire need for more physicians in this country, and fewer students opt to pursue a medical education even as demand for medical services grows. While America's physician population grows older, the math simply doesn't work in the patient's favor: The American Medical Association says 35,000 doctors per year reach retirement age while U.S. medical schools only graduate 8,000 new doctors annually in replacement.
The problem is exacerbated by a growing sense of discontent among younger physicians, driving them out of the profession. Last year, for example, the Massachusetts Medical Society found that more than one-third of doctors in the Bay State were considering abandoning the profession because of high stress, increasing administrative burdens, skyrocketing malpractice insurance costs, and the constant threat of lawsuits - conditions affecting physicians across the country.
In rural America, the problem is even more acute. In places like my home state of Missouri, physician shortages in rural communities have been a longstanding challenge to providing residents with quality health care. Average wait times to see a specialist - when you can find one - in many places are measured in weeks. In some locations, patients may need to drive an hour or more to find a doctor. Many go without.
The University of Missouri School of Medicine and other med schools have created innovative programs to encourage medical students to practice in underserved rural communities, but it's not enough. Jack Colwill, professor emeritus at the University of Missouri, co-authored a report in the May/June 2008 issue of the medical journal Health Affairs predicting a 44,000 shortfall in family and general practitioners by 2025 as more and more students chase more lucrative careers in nonessential specialties.
The promise of universal health care is attractive, to be sure, but the implications of such a remedy may be worse than the cure. We need only look to our north, to Canada, to understand the detrimental effect universal health care will have in our own country.
A 2006 survey by the College of Family Physicians of Canada found that, despite universal health care, 17 percent of Canadians go without regular care because they do not have a primary care physician. There simply aren't enough doctors to meet the demand.
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