NYT, Robert Pear Panel on Health Care Work Force, Lacking a Budget, Is Left Waiting
One of the biggest threats to the success of President Obama’s health care law comes from shortages of doctors, nurses and other health care professionals. But a 15-member commission created to investigate the problem has never met in two and a half years because it has no money from Congress or the administration. Emphasis added
It is a bit confusing why the administration is included in that statement. The author goes on to clarify the ultimate reason, if not why he misled readers in the opening paragraph.
The commission was created by the 2010 health care law, the Affordable Care Act. Mr. Obama has requested $3 million for the panel in each of the last two years, and some Democrats, like Senator Tom Harkin of Iowa, chairman of the Appropriations subcommittee on health, have supported the request.
But, Republicans in Congress have been reluctant to provide money for anything connected with the law, which they opposed. Emphasis added
I suppose as chief administrator, Obama could have taken from other agencies to come up with 3 million - as long as he wasn't over ruling congressional appropriations. I think if that is how Congress expected this to happen when the law was passed, we would be seeing a lot of legislation doing that. Just to add more stupidity, GAO appointed commissioners cannot have any contact on their own time, until it is funded. No emails, letters, phone calls, etc.
Dr.[Richard] Krugman said, “We were told that we were to have no conversations until we were funded because that would be a violation of some federal law or rule.”
Chuck Young, a spokesman for the accountability office, said, “Agencies generally cannot conduct business without an appropriation.”
Apparently, the severity of this situation doesn't overcome 'generally'. Because the GOP thugs would jump all over the GAO and make them look like those stupid, ignorant, partisan bureaucrats they love to hate?
GAO Announces Appointments to New National Health Care Workforce Commission September 30, 2010) – Gene L. Dodaro, Acting Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO), today announced the appointment of 15 members to the new National Health Care Workforce Commission.
The Patient Protection and Affordable Care Act created the Commission to serve as a national resource for Congress, the President, and states and localities; to communicate and coordinate with federal departments; to develop and commission evaluations of education and training activities; to identify barriers to improved coordination at the federal, state, and local levels and recommend ways to address them; and to encourage innovations that address population needs, changing technology, and other environmental factors.
The Act requires the Comptroller General to appoint the Commission members and the members are required to be appointed for three-year terms, but staggered terms are mandated for the first 15 members appointed in September 2010. Those first set of appointments are set at one, two, or three years.
So of the 15 appointed 9/30/2010, the terms of 5 expired 9/30/2011, 5 expired 9/30/2012, and the final 5 terms expire 9/30/13. I am jumping to the possibility that the terms won't officially start until the commission officially starts meeting. Assuming they are still alive.
This is the GAO, officially:
Our Mission is to support the Congress in meeting its constitutional responsibilities and to help improve the performance and ensure the accountability of the federal government for the benefit of the American people. We provide Congress with timely information that is objective, fact-based, nonpartisan, nonideological, fair, and balanced.
There is a lot of nonideological, fact based information on this problem from other government agencies we pay for.
The Department of Health and Human Services said, “The United States faces shortages of primary care physicians, dentists, nurses and other health professionals.”
Edward S. Salsberg, director of the National Center for Health Workforce Analysis at HHS, said 57 million people were living in areas with shortages of primary care practitioners.
Roger J. Moncarz, an economist at the Bureau of Labor Statistics, said that employment in health care occupations was expected to grow by 29 percent, with the addition of 3.5 million new jobs from 2010 to 2020. Federal officials expect 712,000 new jobs for registered nurses — more than for any other occupation in the country.
It seems to me the GAO is falling back on their accounting focus. No funds, no accounting. Can the CBO justify it's projections on the ACA without taking into account the shortages? Did they do that?
This needs some bold, speedy action. Not going to happen. The GOP wants the ACA to be a big nightmare - proof that it was a BAD idea. Except the shortage problem has been hanging over our heads for a decade +. If the entire provision of service was by for profit insurance paying the bills, there would still be shortages of this degree. This is a means for temporary government paid programs to increase jobs in America - for decades to come.
Meanwhile, you can expect to see a lot of foreign workers getting green cards to take health care jobs here. The institutions they work for will not be able to get away with what smaller businesses have done in offering salaries significantly below the other employees doing those jobs. I have nothing against the concept - if there aren't plenty of Americans to fill those jobs given some training. 9 years for a physician to be independent at the GP level is close to the 10 year forecast. 11 is more likely for the majority of PCPs. We can shorten that 4 years getting students with appropriate 4 year degrees (Bio, Biochem, etc) to choose medicine for a career. Unfortunately the working conditions really suck and money is not a compensation for a lot of 20 somethings.
RN's need 2 to 4 years. Given the MD shortages, we really need to increase the % of BSNs in the mix - RNs are the first to catch patient symptoms or trends the doctor has to address. Studies show a decrease in patient morbidity and mortality when the number of BSN nurses are higher on a unit. People with BS degrees they aren't using could transfer into a BSN program with maybe 1/2 -1 yr of anatomy, physiology and other pre reqs. Boomer RNs like me could become NPs in two years with enough financial support. CNAs are also essential to patient safety and quality of care. They take most of the vital stats and have to have time to report appropriately to the RNs.
Meanwhile there are other highly trained medical workers that will be short who need a lot of college education: PT 6 years, PTA 4, Pharmacists 6 , ST 6, RD 4, OT 4, Dentists 8, NPs and PAs 6, just to cover the best known. There are plenty of others in 2 - 4 year tech degrees for lab work, sophisticated testing - even as assistants to doctors, dentists, etc. And before they can get their degrees, there have to be enough college educated professors to do the teaching. Yeah, shortage there for years.
I don't think we could come up with how many people with marijuana convictions have been cut off from these career options. Probably would make my head explode.
I hope this has made you adequately upset. Had a conversation with my Rep, Ed Perlmutter (CO 7-D) 7/4/09 to present a paper on this problem for nurses specifically. I had found out when the bill was signed this commission was in it. I've been a bit peeved since running across this yesterday. I am trying to get together a contact list of government agencies, major providers and professional organizations to contact. I have an errand to do. If possible I will put it on as an update. Start with your Congress Critters and other elected people and agencies .