The current structure prevents to meet the new demands caused by the increase of over 65 years and the income of 35 million health reform system.
The increase of the population that goes into 65 and the addition of 35 million people to health care in 2014, aided by the entry into force of an essential part of health reform, they will cause in the United States increased demand of doctors and specialists that the country is not prepared to meet. The prestigious American Association of Medical Colleges (AAMC) provides the data of shortage in 2020 as 91,500 physicians, a figure that could exceed 130,000 in 2025. Although the AAMC has expanded the number of enrollments in medical schools to try to alleviate the problem, the quota limit admissions for residence period fixed by law since 1997, and the lack of federal funds to subsidize the formation, prevents all graduates to pass aggravating prospects.
According to the Census, every day, 10,000 Americans turn 65, the age at which you are entitled to access to Medicare, a system of social security coverage of federal character. ‘From that age, one is increasingly dependent on health care, are more likely to get sick, chronic conditions are more common and more necessary to have medical, family and specialists,’ explains Dr. Christine Mitchell, director of AAMC Federal Affairs. Mitchell warns of worrying lack in the years of general practitioners and other specialties (predicted to be 45,000 and 46,000 less, respectively), which are the more they will demand the generation of baby boomers, those born between 40 and 60 in the US, when there was an explosion in the birth rate. ‘But it is that not only does the number of patients 65 years, but also the number of physicians over that age who will retire in the next five years, just as more Americans are going to need attention,’ explains Mitchell.
The AAMC is trying to mitigate this situation increasing the number of places in the universities of Medicine and supported several legislative initiatives in Congress to increase the number of residents and financing their education programs. On the first front, it has been that 2013 will become the year with more requests for medical study in history (48,014, an increase of 6.1%, according to their data). But this effort strikes the Budget Reconciliation Act of 1997, which establishes a limit of 26,000 seats per year for the first year of house job, ‘an essential training in the US in order to independently practice medicine,’ says Mitchell. This amount is not enough, according to the AAMC, to provide training to the number of graduates which is expected for 2016.
A shortage of places must be added as the residence system financing, part of which depends on federal funds provided by Medicare. The proposed budget cuts a reduction in the allocation for medical practices in hospitals, which would result, as calculated by the AAMC, in a loss of 73,000 jobs, a circumstance that resent the level and quality of education when more specialists are required.
This is where comes into play another battle waged by AAMC, to convince Congress to raise the number of residency positions and take steps to improve the system. At present, there are four bills on Capitol Hill pursuing that goal ‘but still no sufficient support from both parties in order to begin to the debate,’ laments Mitchell. If approved, it would get extended in 4000 the number of doctors, thus, reducing the lack of physicians in 30,000 in the next decade, one third of the expected shortage in seven years. ‘It does not solve the problem, but given the concern to limit public spending as much as possible which is a perspective that seems realistic,’ says Mitchell.
The AAMC does not believe that the deep political debate about Obama’s health reform both inside and outside of Congress can affect the progress of bills Capitol. ‘We’re putting the emphasis on growing number of Medicare beneficiaries and issues affecting that coverage to all political matters regardless of its position on Health Law,’ says Mitchell.
However, 35 million beneficiaries of health system to be incorporated from 2014 also contribute to the problem of shortage of doctors. ‘These are people, who in many cases, have never done basic tests and now will have to make, this intensifies the demand for physicians,’ says Mitchell.
If this problem is not solved, AAMC warns about increased waiting times in health care of patients, the disappearance of doctors and specialists in the population centers and the danger of assistance to people at risk of exclusion. ‘The time to wait for prosthesis or an operation will double and many patients will find themselves with logistical problems as they have to travel for treatment in the absence of professionals. And this is something the whole country will suffer from, not just the drug users,’ explains Mitchell.
The other concern is the lack of employment prospects for future medical graduates in absence of sufficient places for house job. ‘The problem is no longer for this generation, the problem is for the future, we run the risk of brilliant minds consider making another career that offers guaranteed safer work,’ laments the doctor.
Data of Shortage
• In 2020 foresees a lack of 91,500 doctors
• That figure is expected to exceed 130,600 in 2025
• The lack of primary care physicians is estimated at 45,000
• The lack of specialists and surgeons is estimated at 46,000
• In 2020, it is expected to retire 250,000 doctors
• In 2014, 35 million Americans will join the health system by the entry into force of part of health reform
• The average time between the start of a career in medicine and the practice of the profession is seven years.
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