As thousands of newly insured patients seek treatment under the Affordable Care Act, will they be able to find a doctor to see them?
The problem will be particularly acute in states like Oregon with large, sparsely populated areas and uneven distribution of providers.
At the same time, the cost of a medical education and the crushing debt of graduates limits the number of relatively low-paid primary care medical practitioners.
Oregon Health & Science University is asking the Legislature to provide nearly $5 million over the next two years to pay tuition and fees for 40 students each year, who would promise to work after graduation in the state’s underserved or rural communities.
In making the case for its Scholars for a Healthy Oregon Initiative, OHSU notes that nearly 400,000 people in Oregon are expected to be newly eligible for health insurance next year, but there’s no comparable surge in the number of doctors, nurses and others to care for them.
And with average debt levels ranging from nearly $45,000 for nurses to close to $200,000 for doctors and dentists, graduates are less likely to choose lower paying primary care, and even less likely to work in even lower paying rural communities.
In 2010, only 10 percent of Oregon’s doctors practiced in rural areas, OHSU reported, where 37 percent of the state’s population lives.
The plan, presented in Senate Bill 2, would require successful applicants to work in a designated area for the same number of years as their training, plus one. If they failed to do so, they would be required to reimburse the program plus a penalty.
Although we favor the idea behind this program, we do have two concerns.
First, the proposal says that preference will be given to applicants who are Oregonians, first generation students, come from a rural university and/or “represent a diverse or rural background.” That’s because “research shows that students who are from a rural or underserved area are six times more likely to want to return to that area.” Legislators need to carefully examine the justification for this preferential treatment and be sure it’s valid.
Also, legislators should assure themselves that OHSU is moving to increase the number of its graduates, not just get taxpayers to pay for some of them. The Affordable Care Act will increase the need for medical professionals nearly everywhere.