Word: reform
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This matters because we are about to have a fateful conversation about the end of life. We can talk about reform and prevention and digital medical records, but it will remain true, as President Obama observed, that "those toward the end of their lives are accounting for potentially 80% of the total health-care bill." If we really are going to change how we spend money on health, it means we must change how we spend money on death...
...House and Senate prepare to embark on their summer recess without having passed any health-care-reform bills, President Obama's dreams of radically restructuring the system have, at least for now, bumped up against the reality of Washington politics. But even if Congress manages to overcome the many obstacles and pass some kind of meaningful reform this fall, the goal of covering some 50 million currently uninsured Americans will encounter a whole new range of hurdles. Chief among them is that there almost certainly won't be enough doctors to care for that many new patients. (Read TIME...
Even without reform, experts on the health-care labor force estimate there is currently a 30% shortage in the ranks of primary-care physicians. Fewer than 10% of the 2008 graduating class of medical students opted for a career in primary care, with the rest choosing more lucrative specialties. That could pose problems if a national health-care bill is enacted. After Massachusetts enacted mandates for universal health insurance in 2006, those with new coverage quickly overwhelmed the state's supply of primary-care doctors, driving up the time patients must wait to get routine appointments. It stands to reason...
...nurse-practitioner profession was created in 1965, the same year as the invention of Medicare, which dramatically increased the need for primary-care providers. Yet while nurse practitioners can be valuable assets in the context of health reform, they have also created a conflict with doctors, many of whom are not keen on being supplanted by providers with far less training; doctors in some cases have lobbied to restrict the services of nurse practitioners. "In some situations, it can be a turf battle," acknowledges Rebecca Patton, president of the American Nursing Association...
President Obama told the American Medical Association in May that the government should do "more to reward medical students who choose a career as a primary-care physician and who choose to work in underserved areas instead of a more lucrative path." As part of health reform, the Administration wants more money for the National Health Service Corps, which offers loan forgiveness to primary-care providers - including nurse practitioners as well as doctors - who agree to work in rural and remote areas. But even if these measures encourage more medical students to pursue careers in general practice, it will take...