Two Years From Now, What Will Doctors Be Saying About the Affordable Care Act?

Editor’s Note: Reposted from the new, streaming Wall St. Journal feature “The Experts”—an exclusive group of industry and thought leaders who will engage in in-depth online discussions of topics raised in this month’s Unleashing Innovation: Health Care Report.

This column is based on the recent WSJ article, Health-Care Costs: A State-by-State Comparison.

By Atul Grover, MD

How is my team going to care for all of these patients? Before the ACA passed, numerous experts projected that the nation would be short by more than 100,000 physicians in a decade. We knew we were suddenly insuring 30 million of our neighbors and 10,000 baby boomers were turning 65 every day. We knew these patients would immediately need access to primary-care providers and that they would need care from surgeons and other medical specialists to deal with their advanced arthritis, cardiovascular disease, and cancers once diagnosed. I’ve got other health professionals seeing the right patients but they can’t do it all.

Well-meaning policy wonks assured us that Accountable Care Organizations (ACOs) and other reforms were progressing, but we knew the system couldn’t change overnight. Prevention and medical care will keep us alive longer but cannot keep all of us from ever getting sick, being in a car accident, or being a victim of gun violence. Lawmakers repeatedly have cut funding for teaching hospitals, forcing them to eliminate services and train fewer, not more, physicians. Medical schools successfully boosted enrollment all over the country, but Congress still hasn’t eliminated the 1997 freeze on support for physician residency training. Bills like the bipartisan “Training Tomorrow’s Doctors Today Act” and the “Resident Physician Shortage Reduction Act of 2013” were introduced, but every day that Congress hasn’t acted prolongs the shortages ignored by both parties.

Now, despite repeated opportunities for Congress to expand the workforce, my patients wait weeks to see a cancer specialist. They wait months in pain before they can get their knee replacement.

I can’t get my patients the help they deserve, all because Washington refused to do what was needed and sought to cut health-care spending to the bone. I want my patients to have insurance—but I want that coverage to mean something.

grover-Atul Grover, MD is Chief Public Policy Officer of the Association of American Medical Colleges. Follow him on Twitter @AtulGroverMD.

0 thoughts on “Two Years From Now, What Will Doctors Be Saying About the Affordable Care Act?

  1. Great post that really puts a human face on this problem. We have less than a year to prepare for what is anticipated to be a massive influx of patients into the health care system. Given the length of medical education, it’s unlikely that enough physicians will be ready in time. Other health professions, such as nursing, will need to increase their numbers as well to fill the gap in the short term. In addition to congressional action, medical school and university leaders will need to prioritize health workforce development and start looking for innovative solutions. Any ideas?

    FYI, a similar article on this topic came out just yesterday in the WSJ, highlighting the AAHC:

  2. I was under the belief your organization was committed to teams. NPs, PAs and physicians working together to bring care to more and more people yet not a word was said about team practice.
    Dave Mittman, PA, DFAAPA