Looming Doctor Shortage as States Opt Out of Health Exchange

It is being buzzed around again that there is a major shortage of doctors and the over-utilization of emergency rooms will only sky rocket as a result. Why is this continuing to happen in the coutnry that "brags" about having the best health in the world ? The question still remains is what's the use in having the best medical tech and medicines if either not enough can afford it or worse if thier are not enough professionals to provide it. CNN reported that the American Association of Medical Colleges has predicted this trend will worsen. But, the AMA nor U.S. HHS have figured out why is this the case and there appears to be no current plans to combat it( In actuality, the World Health Organization has ranked the United States health system at # 37 of developed countries). As a growing population of baby boomers live longer with more chronic illnesses that are usually addressed by generalist(family practitioners, general practitioners, internist, gynecologist) , simultaneously there happens to be more physicians either retiring, semi-retiring , changing to specialties with higher compensation or leaving medicine altogether. The shift in the physician population ratio to number of treatable chronic illnesses is at a tipping point. The rapidly rising need of physicians may potentially overstress and overburden a system that is already overtaxed by increasing rates on treating rising illnesses. The 1969 GMNAC Report predicted this would happen. However, the medical community overestimated the altruistic beleif that younger doctors would be driven into general medicine on faith alone.On the contrary, younger physicians have been lured not so much into general medicine, but rather higher procedure oreinted sub-specialties that can be more profitable and help keep up with the driving costs of care and running a practice. Another issue that will effect the provisions of the new healthcare act will be states who have decided to "opt out". There are now 14 states who will not accept the new program as they say federal subsidies will not be made available to create them . These states say there are no provisions in their own state budgets to subsidize this type of program. Other concerns raised are if there are no adequate coverages by the states or federal system which mandates all citizens to "buy" into it , where does that leave us.The states have until next October to have an healthcare exchange up and running. These issues are compounded with systems such as Medicare and Social Security being put on the chopping block for reduction in spending and entitlements are being seriously revised because of the unsecured liability costing the tax payer. Prevention as an inherit measure of a healthcare system is more dire than ever, but has never been considered as a daily aspect in solving many of the chronic illness issues(This is not just the yearly physical or other yearly checks , but daily life measures). It has been shown in several academic and corporate models that prevention through lifestyles programs, wellness programs and worksite health promotions, that reduction in healthcare costs could be drastically reduced(some have reported as high as 75 %). Why isn't a real prevention healthcare plan with lifestyle management not considered as a real force to help reduce not only cost, but rates of illness rising and to educate the youth. The exponential rate in healthcare cost and the rising rate of preventable morbidity and mortality could be introduced now as a real measure. Resources from the USHHS, USPHS, CDC, NIH, schools of public health, and corporate models need to be utilized urgently to produce an effective prevention program to secure an effective coverage program. One can not work without the other.

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