Lower Than Ever Medical University Enrollment Rates And Their Effect On Internal Medicine In Texas
By: Cory Ellerd
Submitted: 2010-06-09 15:21:45 | Word Count: 1199
Until there is a achievement of the recent political debate, the healthcare industry will be in limbo. An identical thing occurred
when Hillary Clinton was leading the push for healthcare reform in 1993.
Lower Than Ever Medical School Enrollment Rates
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30 years ago, about 730,000 youthful hopefuls enrolled into medical academies with the dream of becoming a doctor or medical researcher. This may be contributing to the baby boom generation, or it may be attributing to a generally decreased interest in the medical field in this country. According to the American Medical Association via the Association of American Medical Colleges, it was hypothesized that this year, that number will have dropped to in the area of 540,000 enrollees. In 1980 the United States' populace was 226,545,805. That number will have increased to 310,232,863 by this year. With approximately a 25 percent fewer medical students enrolling into med school, and 85 million more people to care for, this only goes to exacerbate the physician impending doctor shortage.
Until the recently approved reforms to healthcare are realized, and to the current political shifts and prospective resulting consequences are also, the healthcare industry will be in limbo. The current climate in the industry is very similar to what happened when Hillary Clinton was rallying the push for healthcare reorganization in ‘93. Only when it becomes apparent what the future will be, hospitals and physicians are unable and uneasy to make plans for the trying times to come.
The new health care reform, recently signed into law, from Obama claims to:
* makes insurance providers more reasonably priced by providing the largest middle class tax reduction for health care in history, reducing premium
costs for millions of families and small business owners who are priced out of coverage today. This helps over 31 million Americans afford health care who do not get it today – and makes coverage more reasonably priced for many more.
* set up a new competitive health insurance market giving tens of millions of Americans the exact same insurance choices that members of Congress will have.
* bring greater responsibility to health care by laying out appropriate rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.
* end discrimination against Americans with pre-existing circumstances.
* put our budget and economy on a more sure path by reducing the deficit by $100 billion over the next ten years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.
It is also clear from their presentation that they are expecting attacks based on price to the American Taxpayer and to the idea that both Social Security and Medicare are at risk, that the change will simply rob Peter to pay Paul. These concerns are addressed upfront: "The Act will protect and preserve Medicare as a commitment to America’s seniors. It will save thousands of dollars in drug costs for Medicare beneficiaries by closing the coverage gap called the “donut hole.” Doctors, nurses and hospitals will be incentivized to improve care and reduce unnecessary errors that harm patients," and further they state: "The financial health of Medicare will improve and guaranteed benefits will be preserved by ending the 14% average overpayment to private insurance companies under the Medicare Advantage (MA) program." So not only are they protecting Medicare, but they are reducing costs, almost a hat trick.
Weak Economy
With the current economic hardship and enormous job losses across the country, these have unswervingly affected the cash flow to doctors and physicians. When jobs are gone, the loss of healthcare benefits is unavoidable, and so access to health care is also. However, many doctors are postponing retirement since watching the stock market wipe out their retirement funds. This delay will result in a much smaller number of employment opportunities being offered and residents who are completing residency not finding as many accessible jobs as before. Residents today seem to prefer not to commit to less attractive career opportunities, and are choosing locum tenens opportunities. They are also putting off committing to full-time employment because of the scarcity and lower remunerations. So in the predictable future, it appears there will be less and less good career opportunities available.
Demographics: TX and USA
In the United States, the population of 65+ is going to double by 2035 and will reach its peak being almost one fifth of United States residents. In Texas alone, 62.2% of the inhabitants are between 18 and 65. That accounts for around 15 million more people who will have passed the retirement age in 45 years. There are currently less than three, some studies show less than two, million individuals over the age of 65 at present. At the current rate of resident growth for the state, that is a very steep and sudden climb for any demographic. Even though older citizens are healthier than previous generations, the numbers of disabled and chronic condition sufferers are on the rise. So the demand for health care will rise for the next 25 years and beyond. This is the driving force behind the constant growth for demand of physicians, which may result in shortages of available medical services.
Aging is also directing the supply of physicians. Up to 1/3rd of the current six hundred and fifty thousand practicing physicians will be considering retiring by the year 2020. The state of Texas will be left with less than 30,000 of todays physicians to care for over 30 million people. A shortage of primary care physicians, such as Internal Medicine physicians, is a unique concern due to this, and also the picking of younger doctors to choose to further specialize. The reason behind this is that further specialization beyond general care is needed for higher salaries to pay for their high-priced education. The scarcity is expected to hit rural and underserved areas the hardest.
Even with the health bill conclusively signed into law its effect on our health care is not known. By 2014 their will be an enlargement in the enrollment into health care insurance programs. This boost when, combined with the long term aging of the population, should push demand for services and therefore cost higher. However, no one yet knows what will happen to reimbursement rates from Medicare and this new program. The question is will there be rate a cut of reimbursement rates for different specialties by Medicare and this new program that may conversely become a decreasing factor of the income of all specialties, including Internal Medicine.
Clearly the Obama administration has its plate full. We are growing older and there are fewer young people to carry this growing financial burden. The Sins of the Fathers.....
