In Part III.a, I outlined the healthcare provider variable that is currently impacting the delivery of healthcare services. There is a shortage of the front line provider and the shortage is only going to grow worse in the decades to come. This shortage also has an impact on the cost of delivering healthcare services as well as the availability such services to all citizens.
The shortage of qualified physicians, especially general practice physicians, and other healthcare providers is a crisis that will only get worse over the next two to three decades. The education and training is both time consuming and expensive. Based on the need to counteract this crisis, it is only appropriate that the federal government should become involved. It should take on a role that is both supportive to the current system and active toward the improvement of service delivery to the un-served and to the underserved within the population. This can only be achieved by placing control of the program/s under direct control of the U.S. Public Health Service.
The first step is to use public funds to open 50 new government owned and operated medical schools and teaching hospitals. These schools and hospitals would be established in underserved areas of the nation. Although owned and operated by the federal government, these institutions would be staffed by a combination of public health professionals and private teaching professionals. The ultimate goal is to graduate 100 new doctors per year from each institution for a net gain of 5,000 new physicians each year. The primary focus would be on those fields of study with the greatest need such as general practitioners and family medicine. Not only would the public medical schools train new physicians, but also other healthcare professionals; including physician assistants, dentists, and nurses. Included would also be graduate school candidates for PhDs in medical research.
The cost of the education and training of public health medical schools and teaching hospitals would be free of charge to the students with an agreement of a period of service in the public healthcare system or military. Recommended would be that physicians would serve for eight years, physician assistants, PhDs and dentists serve for six years, and nurses for four years.
The second step is to establish public hospitals and clinics in the most underserved areas of the nation. These clinics and hospitals would be staffed by graduates and others from the public healthcare medical schools, serving out their terms of service. Service fees for the hospitals and clinics would be based on the patient’s ability to pay for such services. There would be a sliding fee assessed based on the ability to pay. The public hospitals and clinics would also accept insurance third party payment for such services. Included in the hospitals and clinics would also have government funded pharmacies.
The funding of the program could be easily achieved along with additional funding to Medicare, Medicaid and CHIPS by assessing a National Sales Tax of 5% on all retail sales and services, excluding food and prescription drugs. This would generate an estimated $211 billion per annum. This would be more than enough to satisfy present and future requirements until the nation can transition to a NHS.
By increasing the supply of healthcare delivery personal, the impact could force a reduction on the cost of the healthcare delivery with the government funded hospitals and clinics providing a downward pressure on service delivery costs.