Health law may worsen primary care doctor shortage

NPR: "The new health bill signed by President Obama includes an incentive for doctors to serve the poorest patients by increasing their federal Medicaid payments. This could be quite a significant inducement, as an additional 16 million people are expected to join the Medicaid rolls in the next 10 years."

"What's not clear is whether getting people into Medicaid will actually get them in to see a doctor" (Rovner, 4/5).

Great Falls Tribune: "Nothing Congress has done to reform the nation's health care system will address a serious national shortage of primary care doctors. The shortage of 16,643 general practitioners affects areas with a combined population of about 65 million people, according to federal health officials…The problem is especially acute in largely rural states such as Montana, where attracting doctors always has been a challenge."

A major problem is that "graduate medical education is government-funded through Medicare," and "Medicare caps the number of residency slots it subsidizes — a key factor in the supply of physicians. The cap, which spans all specialties, was set in 1996 to prevent a glut of doctors. It's been frozen at 100,000 slots for more than a decade, even though the population has grown. Lawmakers proposed raising the cap by 15,000 slots at the start of the health care debate last year, but that proposal died — partly because of its $1.5 billion annual cost to taxpayers" (Jansen, 4/5).

Related, earlier KHN story: Primary Care Shortage Could Crimp Overhaul (Mertens, 3/22)

Clarion Ledger: "Mississippi already has the nation's largest shortage of doctors. It also has more than half a million people who could gain health insurance when the law takes effect. … As Mississippi's only medical school, [University of Mississippi Medical Center] produces at least half of the doctors in the state. The medical school has been working to increase enrollment, but budget issues have slowed the efforts. The goal is to get each entering class up to 165 students, but [UMC dean Dr. James] Keeton said adding 30 more people won't be possible without more money. 'I think we'll be stuck at 135 for at least the next two years,' he said. … According to the Association of American Medical Colleges, Mississippi has 63.8 active primary care physicians for every 100,000 people. The national average is 89.6" (Crisp, 4/5).