Ignoring Shortages Will Shortchange Health Care Reform

While the debate grows hotter about how Americans will be insured and where the money to pay for it will come from, there’s little talk about how our already stretched health work force will care for the newly insured. We already know that there is a health care work force shortage now and that it will grow as our population ages. To truly reform health care and ensure safe, high quality service for everyone, the issue of training more workers needs to be addressed.

Most of the proposals currently under consideration pay little more than lip service to the issue. There are provisions to reform Graduate Medical Education, the system that pays for physician residencies, to provide for more primary care physicians. While the country is suffering from a shortage of primary care physicians, the shortage of nurses, pharmacists, physical therapists, technicians, and other skilled health care workers is just as dire.

What is needed is a truly comprehensive plan to address the need for more health care workers. At the very least, a state level plan should be developed that includes measurable goals and makes accountability clear. Without a road map, we are bound to take a wrong turn. In fact, millions of dollars and thousands of hours have already been invested in addressing the shortage. In Washington, we’ve doubled the number of nursing graduates over the last five years. Still, we know even this tremendous progress is inadequate to meet demand. Why? Because a number of organizations are working on the issue in an uncoordinated way and no one is accountable for results. Washington State does have the benefit of the
Workforce Training and Education Coordinating Board to help coordinate efforts here. But on a national level, efforts are duplicated. Time is spent reinventing methods for one segment of the industry that have already been proven effective in another.

Only the Senate HELP Committee’s Affordable Health Choices Act calls for a comprehensive plan at the national level as part of health reform. Hopefully, as the reform proposals move forward, a plan to staff the hospitals and health care facilities to provide care for the millions of newly insured patients is included. If the plan will not be developed at the national level, then Washington State needs to develop its own. Otherwise, we can be sure that the health work force shortage will only be exacerbated, and fears of long waits for care may be come reality.