Doctors for America

“Are you having trouble finding a doctor who will see you? If not, give it another year and a half. A doctor shortage is on its way,” warns John C. Goodman is his Wall Street Journal op-ed. He’s wrong. According to Businessweek, there’s already a shortage of 15,000 doctors, with projections of a 130,000 shortage of doctors by 2025. So why not increase the supply of doctors to meet the demand of the 30 million new patients ushered into the US health care system with the Affordable Care Act? Currently, doctors are trained through a rigorous residency program, lasting three to seven years, costing $145,000 per year per resident. “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.”

Wait, isn’t this supposed to be an education column?
Internet trolls love to snipe in comment threads about Teach for America, “Imagine if we had Doctors for America – would you want someone performing brain surgery on you after five weeks of training?” Frankly, this is blissfully ignorant First World snark. Partners in Health, founded by the brilliant Paul Farmer, trains community members as public health workers in impoverished settings like Haiti, Rwanda, Peru, and Malawi because they have a severe shortage of doctors. The only reason the United States doesn’t have Doctors for America is because America is not facing a severe shortage of doctors… yet.
Goodman’s op-ed dances around some very important ethical and economic questions, but unfortunately, he abandons them for low hanging fruit like “wait time” at the doctor’s office, which will be probably be the least of the US health care system’s problems in the next decade. Universal healthcare will inevitably create some of the same supply and demand issues that plague the public education system. That’s basic economics. And as doctors increasingly feel overwhelmed and underpaid, they too will burn out and leave the profession for private pastures.
I wonder if the internet trolls will gripe how lazy doctors have become, as public health professionals across the nation try in vain to address the ailments of 30 patients at a time?
As a moral, socially conscious citizen, it is a popular liberal opinion to agree that healthcare and education are basic human rights that should be provided by the government. But as a society, are we willing to make the commitment (and sacrifices) required to actually provide those rights? Or do we just want to feel better about ourselves by nodding our heads and passing laws without footing the bill for the financial capital and human resources required to make those lofty provisions a logistical reality?
The two-tiered healthcare system that Goodman prophecies is essentially the education system we already have – wealthy people evade the system by paying for high-end education through private schools, while poor/middle class people are stuck with a resource depleted public system. Does America have the capacity to provide high-quality social goods and services to everyone? Or is a two-tiered system inevitable? Is a two-tiered system acceptable as long as the lower-tier provision isadequate? These are uncomfortable questions to ask, especially when politically palatable answers are not always economically feasible. Of course, it does not help matters that our nation’s political “leaders” are busy quibbling over the technicalities of rape instead of solving actual political and economic problems.
If you need immediate cardiac care, would you rather take your chances and wait a year for a top notch doc, or go under the knife with a 22-year old-who learned how to wield a scalpel last week (but was, like, so good at Operation)?
And if neither of these options is acceptable for our bodies, why is it the fate for so many of our nation’s young minds?

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