Healthcare, one of my favorite topics. Primary care has a couple of things working against it and yet access to primary care can help patients manage many chronic conditions like diabetes and asthma in a cost-effective and beneficial way.
Medical education is expensive and by the time they finish medical school and residency, it is not uncommon for MDs to be facing educational debts over $100,000. So they are less likely to go into a specialty that pays a relatively modest wage and into one where they may have been told, “You are too smart to do primary care.”
There is a tremendous need for more access to primary care in rural areas and many states have taken advantage of federal $ for community health centers. Nurse practitioners and physician assistants can play a vital role in meeting the MD shortage and the distribution problem.
Over time, the government payers have shifted dollars to reimburse medical-based specialties more and procedure-based specialties less. This will continue and although it’s unpopular with many, it seems like the right way to go.
Just my political view–BHO does not seem to understand economics very well so I hope he will leave healthcare supply and demand to those who do. The AMA, CMS, AAMC, and schools of nursing can make important contributions to designing a better system. Insurance companies need to be responsive to the changes and not drive them–again just my view–because their incentives are so clearly in the areas of denying or delaying payment.
The best thing we can do is for all sides to stop the “administrative arms race” and have a more straightforward way to verify eligiblity, benefits, and billing requirements and do this electronically.
