Obamacare

How Congress Helped Cause the Doctor Shortage

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Before ObamaCare passed, projections indicated that the United States would be facing a substantial doctor shortage by the end of the decade. Because the new health law expands health coverage, it's also expand to increase demand for health care. But ObamaCare does almost nothing to remedy this.

So is ObamaCare just exacerbating a problem that already existed in the market? Not exactly. As a piece in Bloomberg News explains, Congress placed limits on the number of doctors who can enter the system each year, effectively capping supply and prohibiting it from responding to increasing demand:

With a shortage of doctors in the U.S. already and millions of new patients set to gain coverage under President Barack Obama's health-care overhaul, American medical schools are struggling to close the gap.

One major reason: The residency programs to train new doctors are largely paid for by the federal government, and the number of students accepted into such programs has been capped at the same level for 15 years. Medical schools are holding back on further expansion because the number of applicants for residencies already exceeds the available positions, according to the National Resident Matching Program, a 60-year-old Washington-based nonprofit that oversees the program.

…There's no easy solution. Boosting the number of taxpayer- financed training slots beyond 85,000 would require Congress to allocate money at a time of contentious budget debates. Adding private financing means tapping new sources of cash, such as from health insurers. Importing doctors from overseas is controversial. And training doctors is long-term work, taking as many as 10 years.

Teaching hospitals quadrupled their lobbying budget last year to $2.8 million, according to the nonprofit Center for Responsive Politics in Washington. They support bipartisan legislation introduced this month that would add 3,000 residencies a year through 2017 at a cost to taxpayers of about $9 billion. Deficit-watching Republicans, including Price, say private funding needs to be identified instead.

As my colleague Shikha Dalmia has noted, all this is done in collusion with the American Medical Association, a trade group representing doctors. They're happy to take public funding, and they're also happy to enforce artificial limits on the supply of doctors, which ensures that their fees stay high. 

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  1. Right after I give you props on your alt-text journey, you post an article without any. It was literally as I was typing the comment.

  2. Sorry Suderman, the laws of supply and demand don’t apply to medicine. Nancy Pelosi told me so.

    1. Congress is going to cure the obesity epidemic by amending the law of gravity.

  3. “There’s no easy solution.”

    False. Unbind residency from the Federal tit and make it part of the college costs to doctors.

    1. Well, not a politically easy solution, no.

      You don’t think we give politicians enormous power, vast perqs and status, and a de facto ticket to wealth so they can make hard decisions, do you?

    2. And have many fewer doctors. The cost of medical school is already prohibitive for many. Add another three to five years of 50k a year cost and you’d likely find many of us saying it’s not worth it considering our salaries are declining. Residency is a financial benefit to hospitals. They get a practicing physician who can staff the place, so they don’t have to pay a full physician salary, or even that of a mid-level provider. If anyone should pay, it’s the hospitals, but they don’t have the money, especially the safety net ones that are the site of many residency programs.

  4. Guess this just proves that capitalism doesn’t work, amirite?

  5. Back in 1998 the Feds were predicting a “glut” of doctors.

    Glad we dodged that bullet!

    1. And back during the Carter Administration they set up some kind of review process to make sure that if you opened a new hospital it wouldn’t make it so there were too many hospitals.

      Not exactly sure why too many hospitals are a problem or how anyone would even determine if there were too many hospitals.

      I guess this is why we need to have top men making these decisions.

  6. Caption contest!

  7. WINDMILLS DOCTORS DO NOT WORK THAT WAY!

  8. Wouldn’t it make more sense to first get rid of rules that require doctors for procedures/exams, etc. that don’t actually require doctors? Adopt rules that broaden the scope of practices for PAs, RNs, etc. (w/o physician supervision) so that when Johnny has a strep throat and needs a prescription, he doesn’t need to see a full-blown pediatrician with 4 years of college, 4 years of med school and 3 years of residency. That’s going to free up a lot of doctors to do actual doctor stuff.

    1. Sure, that’s a good start. It’s not enough, but it’s a good start.

  9. I started writing a sci-fi novel about a organized crime gang that runs a string of black market hospitals. Then I was thinking, why don’t I do that? How much demand goes un-met out there? You hear a story now and then about an unlicensed doc or denist now or then – usually involving immigrants. With Obamacare’s “free healthcare” there might be a openning for an ambitious gang of sawbones and quaaks to meet the growing demand.

  10. All we need is a law that mandates that the children of doctors have to be doctors too. Didn’t Diocletian teach us anything?

  11. So the problem is that the government isn’t funding enough new doctors and we need the Feds to be more involved in the health care sector? Are you trolling us or is this supposed to be a serious post?

    There isn’t a government cap on new residencies, there’s a government cap on government sponsored residencies. Huge difference between the two.

  12. There’s no easy solution. Boosting the number of taxpayer- financed training slots beyond 85,000 would require Congress to allocate money at a time of contentious budget debates.

    Getting rid of all unconstitutional funding for doctor training would work just fine. Allowing competitors to the current medical school cartel would work fine.

    It’s only hard if you mean “politically inexpedient”.

  13. As a piece in Bloomberg News explains, Congress placed limits on the number of doctors who can enter the system each year

    No.

    They placed a limit on the number of doctors’ residency programs they will pay for.

    Are you suggesting the federal government should increase its budget in this area?

  14. When we live in an age where doctors can’t wipe their own asses without being afraid of getting sued is it any wonder why fewer people are pursuing careers in medicine?

  15. Now the Obama care is facing new problem in the healthcare bill but there is still a time pending in this matter the government can recover this shortage of doctors.

  16. This article is just plain wrong about the American Medical Association. The reality is that the AMA is actively working to increase the supply of physicians. To help alleviate the physician shortage, the AMA supports medical education reform, including an increase in medical school class sizes, and additional residency slots to train physicians in needed specialties and regions. The AMA is committed to helping doctors help patients, and that includes ensuring that there are enough physicians to treat them.

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