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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: i-node who wrote (11387)	11/17/2009 1:20:17 AM
From: Peter Dierks	Respond to of 42652

Where Are the Doctors to Implement ObamaCare? A University of California chancellor warns that America could soon look like Massachusetts. NOVEMBER 16, 2009, 4:04 P.M. ET. By TIMOTHY P. WHITE Health care reform will fail to achieve its promise of affordable access to medical care unless the nation's physician workforce is substantially expanded to meet the demand that newly insured patients will place on an already over-burdened system. A comprehensive strategy for growing the physician workforce – as well as other allied health professionals such as nurses and physicians' assistants – should be developed and supported with a federal investment at the same time health insurance is expanded to cover millions of additional people. Without this, gaining access to prompt medical care for all patients will become even more difficult. There will be longer wait times for appointments, less face time with a physician and, in all likelihood, delayed diagnoses leading to more expensive treatment and increased risk of complications. One need only look at the experience of Massachusetts, where the adoption of universal health coverage has intensified the physician shortage. Nationally, the physician shortage will persist for the foreseeable future, even without adding tens of millions of people to the ranks of insured. The Association of American Medical Colleges (AAMC) forecasts a national physician shortage by 2025 of between 124,000 and 159,300, adding that universal health coverage could increase the shortage by another 31,000 physicians. Many regions of the U.S. already experience severe physician shortages. Riverside County – located in the diverse and rapidly growing Inland Southern California region – is the only county in the state with a population greater than 1 million to have fewer than 100 M.D.s per 100,000 people, according to a recent report prepared for the California HealthCare Foundation. Furthermore, the physician workforce does not reflect the ethnicity of the population, underscoring health disparities that result in a higher incidence of chronic diseases and higher mortality in minority and low-income populations. Because minority physicians are more likely than non-minority physicians to practice in ethnically diverse communities, it is vital for medical schools to train a diverse workforce of physicians to practice with a clear emphasis on prevention, and with cultural competency and sensitivity. The AAMC has called for a 30 percent increase in medical school enrollments by 2015, and higher education institutions are responding, both by increasing enrollment at existing medical schools and by establishing new schools of medicine, such as the one under development at the University of California, Riverside, in the heart of one of the most medically underserved regions in the state. In the current recession, it is important to note that these new enterprises will also bring new economic stimuli to their regions for many decades to come. New medical schools, of course, bring new jobs and new construction. But they are also generators of new funding in the form of federal grants for biomedical research and clinical studies, the most promising of which will complete the innovation pipeline to new business formation. So, too, are they magnets for high tech industry in fields such as biotechnology and pharmaceuticals. In reaching consensus on how best to enact health care reform, President Obama and Congress should be mindful and attentive to the workforce impact of expanding health care coverage. Additional scholarship funds and debt relief for aspiring physicians who choose primary care fields and practice in medically underserved areas are a good start, as is lifting the cap on Medicare-funded residency positions. Federal policy should also reflect the need to develop a reimbursement structure that will emphasize preventive care and entice physicians to practice primary care medicine. But it will take a much greater investment to expand medical education opportunities. Economic stimulus funds directed at this national crisis will reap both short- and long-term economic impetus, in addition to the vast social benefits of a healthy and productive U.S. populace. Because it takes at least seven years to train an independent practicing physician, the urgency is acute. We must start training future physicians now. Only by producing more physicians and health care practitioners and encouraging them to practice in the primary care disciplines can this nation achieve the promise of affordable access to high-quality health care for all. Mr. White is chancellor of the University of California, Riverside. online.wsj.com

To: i-node who wrote (11387)	11/17/2009 9:03:48 AM
From: skinowski	3 Recommendations Read Replies (1) \| Respond to of 42652

Harvard? Did someone say Harvard? I'm having doubts about the venerable NEJM. It seems they allow their politics to get the better of them. They appear to be pretty much pro-reform. In one issue earlier this month the article on the top of the list is by Sen. Baucus, about his "struggle" for healthcare. While NEJM has a right to have editorial opinions, we need to recognize that they are being partisan. Just like the AMA, they have no right to misrepresent their own political views as consensus opinion. If anything, it makes me question the validity of anything they may publish on this subject. I wish they would stick to science.