California could face doctor shortage


The Supreme Court’s ruling Thursday upholding President Obama’s healthcare law was a surprise to most.  The decision meant that most of the law will continue to be implemented, and that the controversial individual mandate — which requires all Americans to buy health insurance or pay a penalty — is, in fact, constitutional.

Of course, the decision hasn’t ended that debate. The political fight will now shift its focus to the November elections, which could determine whether the law survives into next year or gets repealed.

What isn’t being discussed very often is the small but real possibility that this could cause a care shortage.  Some are concerned that with the influx of newly insured patients, the healthcare system in California won’t be able to keep up.

This comes at a time when the number of primary-care physicians is actually dropping.

Dr. Paul Phinney, head of the California Medical Association, told KCBS:

“The Affordable Care Act is a very good first step, but we are on the brink of a physician shortage.”

He also notes that both Medicare and Medicaid programs are underfunded, and reimbursement rates often aren’t enough.  That puts more of a strain on clinics and hospitals who have to recoup the loss somewhere else.

On top of all that, the law fails to address the fee-for-service model of care utilized in the medical field, believed to be part of the problem of rising costs.  More importantly, the law doesn’t — and really can’t — deal with issues like poor diet and lack of activity that are harming peoples’ health.

Still, as they say, politics isn’t perfect, and getting millions of people insured will help the system over the long-term.  And since the law is still standing, there’s work to be done to make sure access doesn’t become a problem.

One idea is to expand the role of physician’s assistants and nurse practitioners.

As Micah Weinberg, senior policy advisor for the Bay Area Council pointed out:

“The issue is not access, the issue is efficiency.  We need to become more efficient.  If we do become more efficient, we will have access.”

And frankly, this is the United States. We’re innovative people by nature, especially when there’s money involved.  Given how much money is involved with healthcare, I’m sure we’ll figure it out.

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