 merrie says: Add More Residents? 'Dead on Arrival' Almost everyone agrees on how to build up the supply of primary care physicians: create more residency positions at teaching hospitals for family doctors and internists to complete their training and significantly increase how much primary care doctors get paid by Medicare and other insurers. But there’s resistance to these steps because of their costs. A proposal backed by Senate Majority Leader Harry Reid, D-Nev., and the teaching hospital lobby to add 15,000 Medicare-funded medical residency positions -- a 15 percent increase that would favor more primary care training -- was considered dead on arrival because of its $10 billion price tag over a decade. Proponents said it was a small price to pay, in legislation that could run as high as $1 trillion, to ensure that patients have access to doctors. Instead, the House and Senate overhaul bills would redistribute about 1,000 unfilled residency positions . . . . . . to teaching hospitals that commit to creating more primary care residencies. The Senate Finance Committee bill would give 15 mostly southern and western states preference for those positions because they have a high proportion of doctor shortages or a low percentage of medical residents. Ten of these states have representatives on the Finance Committee. Proposals to significantly increase Medicare payments for primary care doctors have gone nowhere in part because the money would come from payments to higher-paid specialists — who, not surprisingly, oppose a pay cut. [...] Family doctors on average make about $173,000, less than half of what specialists such as cardiologists earn, a... |
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