Health Care Law Could Spark Need for Medical Professionals

When the federal health care law goes fully into effect in 2014, it will prompt millions of previously uninsured individuals to obtain health insurance.

One policy analyst at the Missouri Foundation for Health says such a move will spark a bolstered rush for health care services. And he added Missouri – and the rest of the nation – has a lot of work to do to keep up with demand.

“Lots of people complain about the mandate or they’ll complain about components of the law,” said Missouri Foundation for Health policy analyst Thomas McAuliffe, adding that there aren’t enough medical professionals to meet current demands of health care. “And I say ‘you’re really missing out on the biggest problem. The biggest problem is workforce. We do not have a big enough workforce ranging from basic physicians assistants on up to primary care physicians. We do not have of these frontline providers to meet the needs of our population.”

The foundation sent out a press release earlier this week noting that the federal health care law provides financial assistance, tax breaks and student aid for people who aspire to be medical professionals.

Sam Drzymala, a spokesman for U.S. Rep. Russ Carnahan, said in an e-mail that the new health care law will:

-          Expand funding for scholarships and loan repayments for primary care practitioners who decide to work in underserved areas.

-          Redistribute unused Medicare‐funded residency slots to programs that agree to train more primary care physicians and general surgeons.

-          Provide a bonus for primary care services through 2016 and a boost in Medicaid reimbursement in 2013 and 2014. That’s aimed at encouraging younger doctors to go into primary care.

Steve Odegard, a Sunset Hills resident who will be going to medical school at Loyola University in Chicago in 2012, said loan forgiveness tends to be a common incentive that students hear about.

“Programs that have sprung up in the last 10 or 15 years [where] doctors and residents can work in like a non-profit hospital instead of starting in private practice,” Odegard said. “They can then have a significant percentage of their med school loans just forgiven. I think that’s one of the biggest things as a perspective student that you have to be thinking about, because you have to be taking out these huge loans to go to med school.”

Patrick Garrett, Vice President of Physician Affairs at St. Anthony's Medical Center, said there might not be a rush of new patients exactly 2014 arrives. But he said there are numerous trends that forecast an increased amount of people seeking medical care.

“Even without any health care legislation, there’s a significant increase in the average age of the population,” Garrett said. “So there’s going to be an increased in Medicare-aged patients as the baby boomers age. And so, I think from a primary care standpoint – and I’m a primary care physician – is that the likelihood is there will be, and frankly there is now, a shortage of good primary care physicians to see available patients.”

Garrett said there are incentives to increase the pay through Medicare for primary care physicians. But he said that wouldn’t be enough to incentivize people to go into that medical field.

“I don’t know that there’s a quick, easy fix, because I think there are multiple issues,” Garrett said. “Some of them have to do with the payment system as it, which frankly gives a little more incentive to physicians who are procedural based – people who do things like surgeons and cardiologists… One of the health care reform goals is to try and change how physicians are paid in general. And until that shakes out, until that occurs… then it’s kind of difficult to know whether that’s going to drive more graduating medical students into primary care specialities.”

STATE STRATEGY

McAuliffe said there will have to be a “state strategy” to incentivize medical schools into keeping medical professionals in Missouri.

“We have no problem in this state producing primary care physicians,” McAuliffe said, adding that the state is high on the list of the production of primary care physicians. “But I think we’re like 48th in retention… But we have to think of as a state, how can we come up with incentives – be they financial, be they social – to get people to stay?”

“Increasing workforce would not nearly have been as sexy or politically satisfying for either administration or party,” he added. “We would have loved for a lot of attention to be paid for workforce. But if probably would not have passed, because it would not have gotten the headlines. In some ways they did put the cart before the horse, because the horse is the workforce. It’s going to drive a healthier nation.”

Rep. Marsha Haefner, R-Oakville, said she wasn’t aware of any state budget items to deal with the shortage of doctors. But she said it’s an issue is being discussed and will be discussed for the foreseeable future.

“It’s such an unknown,” said Haefner. “The way that the health care mandate is going to affect the states financially and logistically is such an unknown right now that we’re not even sure what direction to go or how to react. But definitely there’s going to be a shortage of medical personnel.”

Haefner said she put forward an unsuccessful amendment to allow for electronic prescriptions, which she said could save time for physicians who are going to experience an increased workload from an influx of new patients.

She added it’s going to be up to public universities to allocate funds so that more medical professionals can go into the state.

“It’s going to be a two-way street,” Haefner said. “It’s not just a legislative mandate to make this happen. I think universities are going to have to maybe restructure where they spend their money based on need and job availability. I mean, that’s why you go to college, I’m assuming, to get a job. If a lot of the good jobs, per se, are going to be in health care, then I think universities are going to have to take on some of the responsibility to change what they do to accommodate their need.”

McAuliffe said the biggest problem may be finding where medical professionals are needed.

“We do not have a statewide data system to tell us our workforce needs,” McAuliffe said. “And we at the Foundation have been working hard to kind of improve our data workforce system. But it has not been an easy kind of proposition. The biggest problem is we don’t know what we need. And how is it that you can go changing what you need when you don’t even know of the depth or the scope of the problems.”