Second Look: Reimbursement and Regulation

Report warns that U.S. health system is inadequate to handle aging population
The National Academies has released a report asserting that the healthcare workforce in the United States will be unprepared to meet the needs of the aging baby boom population. “Retooling for an Aging America: Building the Health Care Workforce” calls for immediate initiatives to train all healthcare providers in the basics of geriatric care and to prepare family members and other informal caregivers to tend to their aging relatives. The report also proposes that Medicare, Medicaid, and other health plans increase reimbursement levels to boost recruitment and retention of geriatric specialists and care aides.

Medical school enrollment projected to increase 21 percent in 4 years
The Association of American Medical Schools (AAMC) reports that more than 86 percent of existing medical schools have already expanded or plan to expand the number of enrollment slots for first-year students within the next 5 years. This expansion, along with the opening of nine new medical schools under development or discussion, would result in an additional 3,400 students per year by 2012, or an increase of 21 percent. Fears of a looming physician shortage had previously prompted the AAMC to recommend a 30 percent increase in the number of medical students by 2015.

NEJM articles look at responses to physician shortage
A pair of articles published in the April 17 issue of the New England Journal of Medicine (NEJM) examines factors surrounding a growing physician shortage in the United States. A health policy report states that although medical schools have begun to increase the size of their first-year classes and the total number of students entering U.S. medical and osteopathic schools last fall was the largest in history, neither the federal government nor the private health insurance industry has taken steps to address the shortage. An accompanying perspective piece questions the need for more physicians and questions why the Council on Graduate Medical Education recently predicted a 10 percent shortfall of physicians by 2020 despite the fact that there are currently more physicians per capita in the United States than at any time in the last 50 years.

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