Specifically, the programs turn out too many specialists who go on to practice in places where such doctors are already in oversupply, and where, according to numerous studies, they often inflate health care spending by engaging in massive amounts of unnecessary surgery and other forms of over-treatment. Meanwhile, residency programs are producing a dwindling number of primary care physicians and other generalists, who are already in chronically short supply in most parts of the country and are desperately needed to implement the kind of reforms to the health care delivery system necessary to improve its quality and efficiency.
One of the biggest drivers of this trend is the lopsided Medicare reimbursement rates that pay specialists at a higher rate than primary care doctors. As a result, around 60 million Americans live in primary care shortage areas, according to federal government estimates. And with Obamacare adding many people to the insurance rolls, these primary care shortages are likely to get much worse.There’s a lot more to the story, of course, and the Washington Monthly piece does a good job of walking the reader through the issues and examining some policy fixes. But what stands out immediately is a clear picture of how an ill-thought out reform like Obamacare can seriously compound existing dysfunctions created by special interests. Read the whole thing here.