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In Our View: Make Health Care Law Work

Sen. Murray's plan to address doctor shortage offers improvement

The Columbian
Published: September 9, 2014, 5:00pm

It’s no secret that the Affordable Care Act is increasing pressure on an already strained health care network. Adding millions of people to a system that was suffering from a well-documented shortage of doctors can only exacerbate some problems.

Yet while some critics have elected to use this scenario as an example of Obamacare’s failings, in truth it points out why improved access to insurance was necessary and why the ACA should be tweaked rather than scuttled.

Consider the abstract to a paper written earlier this year for the conservative Heritage Foundation: “The ACA breaks the promises of access and quality of care for all Americans by escalating the shortage and increasing the burden and stress on the already fragile system.” That would seem to call for one of two solutions: Prevent access to health care for millions — undoubtedly those most unable to afford it — or expand the availability of doctors. Considering that the ACA was passed by both chambers of Congress, signed by President Obama, and upheld by the Supreme Court — and that voters then re-elected Obama — it would appear that it is time to make Obamacare work rather than trying to abolish it.

That brings us to a bill introduced last month by Sen. Patty Murray, D-Wash., which is designed to address the doctor shortage that has been a longtime problem and likely will continue to grow. The Community-Based Medical Education Act would extend until 2019 the ACA-funded Teaching Health Center, which is scheduled to expire next year. “The statistics are clear: If we don’t change our system for medical training, millions of Americans will be left behind without access to basic medical care,” Murray said.

According to studies, the United States is expected to need 52,000 more primary care physicians by 2025, and Murray said that Washington is facing a shortage of 1,695 primary care doctors by 2030.

Relatively few medical school graduates are drawn to general practice, in part because salaries tend to be lower than they are for specialists. But whatever the reasons, the shortages are especially dire in rural areas, which have been chronically underserved. A recent article in The Seattle Times pointed out that the town of Grand Coulee in Central Washington has two family doctors, and demand is so great that those doctors alternate being on call at night and on weekends. In Port Angeles, the shortage of physicians is so acute that a clinic is turning away 250 callers a week. As reporter Lisa Stiffler put it: “The ACA has funding this year for 550 residents in underserved rural and urban areas nationwide. In Washington alone, 28 primary care doctors each year are completing their training in these communities thanks to ACA dollars, ready to practice where they’re needed most.”

Murray’s bill would extend that program, and that extension could prove vital to providing health care to those who need it. As The (Spokane) Spokesman-Review points out, Washington has about 1,600 residency slots for the training of doctors, and roughly 1,500 of them are in the western part of the state. And studies have demonstrated that doctors are most likely to take up practice near where they conduct their residencies.

Undoubtedly, there are shortcomings with the Affordable Care Act, but the good intentions of improving health care in this country is not one of them. Murray’s bill would help solve one of the problems being exacerbated by Obamacare, and that would be good news for many who are in need of care.

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