Hi everyone,
It seems that every time time I read the news I encounter a new article about the need for universal health care. Just today, I was reading about former Senator Tom Daschle, Obama's nominee for Secretary of Health and Human Services, who has plans to hold holiday-season house parties to brainstorm over how best to overhaul the U.S. health-care system.
One subtle aspect that is not being openly discussed is the fact that health insurance does not necessarily guarantee health care access. To prove this point, I just saw an article in the New York Times that relates a new crisis facing Massachusetts universal health care reform: the lack of primary care physicians to provide care for all the newly insured. The article stresses that what has happened in Massachusetts has put " a spotlight on the workforce shortages that don't get meaningfully talked about in just about any other other state." The main point is that Massachusetts is the first to encounter a problem that will confront other states as more people are able to afford/receive health insurance. People will have insurance, but who will accept them as patients? Unfortunately, this is a problem that promises to particularly affect poor and underserved communities.
Why the decreased interest in primary care? Why are so many existing primary care physicians disenchanted? Among the issues highlighted in the articles are high student-loan debt and poor compensation/reimbursements by insurance companies, Medicaid and Medicare for primary care visits--no one pays for the time it takes to fill out enormous amounts of paperwork, take on the insurance companies on behalf of patients or to write sick notes to employers.
What to do to change this situation? As one article states, "the solution is ultimately political, since it requires making sure that our enormous public investment in medical care goes where it will do the most good."
You can take a look at the following articles I just referenced at:
http://www.nytimes.com/2008/04/05/us/05doctors.html?pagewanted=1&sq=primary%20care%20physician%20shortage
http://seattletimes.nwsource.com/html/opinion/2002895859_rosenblatt29.html
http://www.npr.org/templates/story/story.php?storyId=97620520
All the best,
Rosa
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What I think is funny is when I hear people say we should not strive for universal healthcare because we do not have enough primary care doctors anyway. This seems to be more of a problem of reimbursement rates and the lack of incentives to go into primary care, as you so nicely put it, Rosa. Instead of masking the shortage of care without reform, healthcare reform can provide a new challenge to meet. Let's start by reducing paperwork and making reimbursement rates more equitable. What kind of healthcare system will be most amenable to doing that?
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