STATEMENT
Of the Honorable Nydia M. Velázquez, Chairwoman
United States House of Representatives, Committee on Small Business
Full Committee Hearing: “The Looming Challenge for Small Medical Practices: The Projected Physician Shortage and How Health Care Reforms Can Address the Problem”
July 8, 2009

 

American health care is a complex system. To properly function, it requires a myriad of interworking components, from hospital infrastructure to insurance companies and drug researchers. But the most critical element cannot be built or tested in a laboratory-- it is the men and women who make the system run. General practitioners are the backbone of the medical field. They offer basic care, and are responsible for half of all patient visits. But in many parts of the country, these small business practices are becoming an endangered species.  

Today, we will examine the current physician workforce shortage, and discuss its potential impact on health care reform. This issue is of particular concern to our committee, and not just because most general practices are small firms. For one, it affects doctors in all areas-- from surgeons to pediatricians. Physician shortfalls also hinder our efforts to control costs for entrepreneurs, and have the potential to undermine our work towards universal coverage.

In overhauling health care, we are looking to provide coverage that is both affordable and accessible. But we can’t do that without the necessary workforce. In the last decade, the availability of doctors has dropped off considerably-- even for those with gold-plated policies. If current trends continue, the gap between supply and demand may reach 125,000 by 2025.

Fewer physicians mean longer lines in waiting rooms, greater difficulty scheduling appointments, and less time with the doctors themselves. These challenges are more than an inconvenience-- some patients may choose to avoid checkups altogether. That would be a dangerous consequence, one that could blunt the benefits of universal coverage, and drive up costs overtime. 

Primary care is preventative care, and an effective means for reigning in costs. That’s because a person who gets regular checkups is less likely to develop serious conditions down the road. And considering that 75% of health care expenditures go towards treating chronic illnesses, primary care is critical.

The current physician shortage is already posing a significant threat to reform. Reform will bring more uninsured Americans into the fold, but it won’t create more doctors to treat them. Take the 46 million newly insured, add in an aging baby boomer population, and you could very well have a recipe for disaster.

As with anything related to health care, there is no silver bullet solution. Still, a number of possible fixes are under consideration, including provisions to expand health services in underserved communities-- the regions suffering most from the current shortage.  

This body will soon take steps to transform our broken health care system. I think most of us will agree that it is about time. But in moving towards reform, we need to be sure our foundation is strong. It is critical that we have a solid pool of medical professionals to see the process through. Today, I hope we can look for ways to make that happen.