The Cart Before the Horse

Today on msnbc.com, I read an article (written by Philip Rucker, Washington Post) about health care reform and one of the problems not being talked about enough. I have been preaching this problem since day one.

Click here to read the entire article: "Reform May Exacerbate Country-Doctor Deficit; Small-Town Reality: Even With Insurance, You Need Somewhere To Go"

The article discusses the dilemma of providing insurance for millions of people and then those people calling for a doctor appointment -- when there is a shortage of doctors. "A physician shortage has long plagued rural areas. Young doctors saddled with medical school debt are more often drawn to such lucrative specialties as radiology or anesthesiology in big cities or suburban areas, where they can earn double the $120,000 to $140,000 salary of a rural family practitioner."

"But if some or all of the estimated 40 million uninsured Americans become covered under health-care reform and suddenly seek general doctors for physicals and other everyday medical issues, experts say need and supply would collide."

"It's a crisis," says Wayne Myers, a doctor and former director of the federal Office of Rural Health Policy. "The larger picture goes like this: Half the doctors ought to be in primary care, and about a third of the doctors have been in primary care."

"Anticipating the shortage, members of Congress included incentives in the health-care bills, including a loan repayment program to train more primary care physicians and an expansion of the National Health Service Corps to get more doctors to underserved areas."

"The system's going to be overwhelmed when everybody's insured," Dr. Ben Edwards says. "We're putting the cart before the horse. You've got your little insurance card and there's no doctor to show it to -- or you have to wait eight weeks to see one."

Shouldn't we fix this problem BEFORE we add millions to an already strained and ineffective system?