More than one-third of North Carolinians face difficulties accessing primary care doctors. Even worse, on its current path, the Tar Heel state is projected to be short 7,725 doctors overall by 2030, including 1,885 too few primary care providers.
Of North Carolina’s 100 counties, 92 have shortages of health care professionals today. Over time, it’s going to get even harder for citizens to get care. The solution to this very real crisis? Invest in our doctors.
Despite years of rising health costs, Medicare has continued to suppress physician pay, creating an untenable situation for North Carolina’s independent physician practices, which say they are underpaid and undervalued. Many are being forced to sell or shutter their practices because they can’t make ends meet.
Adjusted for inflation, Medicare payments to physicians have dropped 29% since 2001 — creating an uncertain financial future for independent practitioners in North Carolina and nationwide. And, with more Medicare cuts threatened, it is more important than ever for political leaders to address the doctor shortage and not make it worse with short-sighted cuts.
Doctors across the country are being asked to do a lot more with a lot less. As one expert noted, Medicare’s inability to ensure that payments to physicians maintain pace with inflation is “negatively impacting revenue streams for clinicians” who participate in the program. Continuous cuts to physician payment rates are “nothing short of cataclysmic for practitioners,” the expert said. Private health insurers often mimic Medicare policies, so they surely will follow, as doctors in commercial markets also face serious financial shortfalls.
This reality stands in stark contrast to other professionals and facilities in the Medicare program. Hospitals, skilled nursing centers, and hospices receive annual inflationary updates. Yet, physician payments lag behind inflation due to years of continued Medicare cuts, including statutory freezes enacted by Congress.
Unfortunately, this dynamic is worsening the dire doctor shortage in North Carolina. With dwindling payments, many smaller, independent physician practices must cut back on staffing or services, stop seeing Medicare patients, or in worst-case scenarios, close their doors completely. This looming catastrophe will impact our state’s rural population the most, as many patients in those communities already are struggling to get care near home.
We see this trend in countries with socialized systems where the government is the single payer for all medical care, generally setting artificially low payment rates that exacerbate supply and demand problems. A recent white paper from the Pacific Research Institute reveals that the Medicare program is falling into the same traps and pitfalls as Canada, Germany, and the UK, all of which are facing doctor shortages that threaten to negatively impact access, quality, and availability of health care.
As it stands today, many of America’s private physician practices will be unable to meet the growing demand for care from aging Baby Boomers. Unless policymakers fix the problems with our Medicare payment system, the United States will decline toward lower-quality care and long waits for treatment.
The future need not be this gloomy. A bipartisan group of physician lawmakers in Congress, led by Rep. Raul Ruiz of California, is working on a solution that would tie physician reimbursement to inflation. This will help ensure physicians receive annual inflation updates to compensate them for the growing cost of providing care.
This is smart policy because it would stabilize the Medicare program, ensure doctors are being reimbursed fairly, and avoid the slippery slope of the shortages and long waits that we see under socialized systems — all while strengthening access to care, especially in rural communities.
Congress can act this year to show that bipartisanship still works by ensuring fair payments for physicians in North Carolina and the country so patients have access to quality health care.