Obama reforms may be slowed by doctor shortages

A few years ago, when Massachusetts first got rolling on its health reform plan, observers began to notice something odd. Once you got everyone insured, they all needed doctors. And once everyone had access to and wanted care from doctors, you needed more of them--maybe more than you could provide.

That's just the problem that President Obama may now be facing. While his administration would like to push through legislation this year covering millions of the uninsured, officials are having to accept the fact that there may not yet be enough physicians to cover these newly-insured citizens, while addressing the needs of aging baby boomers. Primary care shortages are a particularly big concern.

The question, of course, is how to choose between competing interests in solving the problem.

One key element, most agree, is to raise pay for primary care doctors. Even the Medicare Payment Advisory Commission is recommending an increase of up to 10 percent in reimbursement for primary care doctors, which certainly wouldn't hurt the situation.

The question is, where the money will come from? Family doctors and internists, for example, want to see CMS boost their Medicare payments. Specialists fire back with the argument that Congress shouldn't do that if it means taking money away from them--that any additional primary care funding should be new dollars.

To learn more about this debate:
- read this piece from The New York Times article

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