• Reflex: October 14, 2011

    Physician shortage in Massachusetts continues to squeeze primary care, reports Tanya Albert Henry. “Massachusetts is facing severe or critical shortages of doctors in eight specialties, including a deficiency of primary care physicians for the sixth year, a survey shows.” Shortages were seen in almost half of specialties. Aaron’s comment: Massachusetts likely offers us the best picture of what life will look like after the ACA is fully implemented, and anyone who doesn’t see the doctor shortage problem coming has their head in the sand.

    The Kaiser Family Foundation finds high insurer market concentration in many individual- and small-group markets. “[A] single insurer dominated at least half of the individual market in 30 states and the District of Columbia. In the small group market, a single insurer accounted for at least half of the market share in 26 states and D.C.” Austin’s comment: As with many things in health economics, this is far more complex than is likely to be reported. I’ll explain next week. In the meantime, remember that insurer market concentration is not always bad for consumers.

    • Short Doctors. This has been a huge concern to me since the early days of President Obama’s attempt to extend medical insurance to the currently uninsured. How MA and the USA generally deal with this issue is important to Americans but my concern was and is that one of the obvious solutions is to recruit huge numbers of doctors, nurses, lab workers, and others from English and Spanish speaking countries, i.e. Canada, UK, Australia, South Africa and Mexico, Spain, Argentina.

      The training time for medical personnel is much longer than the timeframe for the first new patient to show up demanding medical treatment. I have seen little indication that this new demand has been recognized nationally in the United States let alone taking steps to supply new personnel to meet the needs. Waiting times for specialists and non-specialists alike could rise dramatically partticularly in markets which have medical personnel shortages today.

      To borrow a phrase from Ross Perot, that giant sucking sound could well be the U.S. stripping other countries’ medical systems of essential personnel to reduce new crisis-level medical wait times throughout the U.S.

    • I don’t want to diminish the danger of a physician shortage in any way but the Massachusetts Report says that the Affordable Care Act will lead to 50 million previously uninsured people getting insurance. That estimate is much higher than any I’ve heard. Are they simply misattributing 16 to 18 million uninsured who will get insurance for other reasons (e.g. qualifying for medicare) to ACA?