|
Three more doctors is a start—sort of
It looks like Senator Grassley has gotten three new Medicare-funded medical residencies for Iowa. That sounds like real progress, but maybe not so much once you realize Medicare funds 85 percent of all residencies and the number has been frozen since 1997. 1997? Come on, really? Yes.
You see, back in the 1980s, several "advisory councils" warned CMS about a future surplus of physicians. Congress agreed and began work to stop the census of doctors from growing too fast. Their efforts have been remarkably effective: Current shortages are projected to reach 124,000-139,000 providers by 2034.
Fast forward a few decades. Yes, a stopgap of 1,000 additional residencies over the next five years was approved in December 2020 and is finally kicking in. However, a somewhat more comprehensive plan, The Resident Physician Shortage Reduction Act of 2007 has been re-introduced so many times, it is now known as The Resident Physician Shortage Reduction Act of 2023. It has still not passed.
So, although we appreciate the three new medical residents to be distributed among Iowa's 120+ hospitals, we can be pretty sure two of them will actually blow out of here as soon as they're finished, netting Iowa only one additional licensed doctor. FYI, Iowa's census of physicians dropped by 358 from 2020 to 2022, continuing a decade-long trend.
I don't know exactly what it will take for federal and state policy makers and stakeholders to acknowledge health care worker shortages and their entirely foreseeable impact on health care access. But I do know this: Whatever it is, it will be painful—maybe even life-threatening—for everyone involved.
| 
