|When the Best Hospitals Are the Worst
Dr. Helen B. Taussig, co-developer of the "blue baby operation," at Johns Hopkins Hospital in 1968. The hospital's pediatric cardiac center is now named in her honor. (William A. Smith / AP)
Assume we successfully get health insurance for 32 million more Americans. Not a single person "falls through the cracks." Every aspect of Obamacare launches and integrates perfectly. The exchange websites are beautiful and intuitive; every state with gaps conjures an elegant fix. There's a quantifiable change in barometric pressure as the nation collectively sighs.
The moment would be fleeting. Panic resumes when the newly insured try to get appointments to see doctors. Overbooked, miles away, or otherwise inaccessible; what does it mean to be able to afford care if no one is there to provide it? Within the decade, the U.S. physician shortage will be around 91,500, with about half of them in primary care. Already today, 60 million Americans live in federally designated primary care shortage areas.
That's the picture painted by demographer and senior research fellow with the New America Foundation Phillip Longman in the current issue of Washington Monthly, where he takes a thoughtful at look at how federal dollars spent training physicians are distributed.
Residency training programs, which are the on-the-job work done after graduating from medical school but before doctors fly solo, are paid for by federal taxes. It costs the government around $100,000 per year to train one doctor. (The resident gets about $50,000 in salary, and the hospital gets the other half.) The 759 institutions in the U.S. with residencies get a total of around $13 billion federal dollars every year.