The Daily Rise: Monday, April 11

Doctor! Doctor!

Morning Consult’s Mary Ellen McIntire shares the results of a new study about the looming physician shortage in the United States. According to the Association of American Medical Colleges, we’ll have “a shortfall of between 61,700 and 94,700 physicians by 2025.”

“These updated projections confirm that the physician shortage is real, it’s significant, and the nation must begin to train more doctors now if patients are going to be able to receive the care they need when they need it in the near future,” Darrell Kirch, the group’s president and CEO, said in a press release announcing the new study. “More physicians retiring over the next decade also will create challenges for patients who need access to health care.”

What’s causing the shortfall? Our aging population. “Between 2014 and 2025, the U.S. population is expected to grow from about 319 million people to 346 million people. While the population of people younger than 18 is expected to grow by 5 percent, the population aged 65 and older is expected to grow by 41 percent.”

You can check out the entire study by clicking here.

Bundled Concerns

Dr. Rafael Fonseca, who writes at the blog, “Patients First,” reveals several concerns with the health care industry moving “towards a bundled payment.” Fonseca warns that bundling create “perverse incentives” that are risky for patients. Two big concerns:

1. Reduces Access to Oral Medications: “An integrated health system discourages patients from receiving support for co-pays associated expensive oral medications. While studies have shown that majority of patients can get support for co-pays this health system stays, by policy, silent and provides no assistance in securing such support. Assistance is only initiated after the patient complaints. A clear game of attrition. The system assumes and hopes that some will just give up – “Its just too hard…”

2. Ties Doctors’ Bonuses to Treatment Decisions: “Doctors that are part of a network have their yearly bonuses curtailed by use of intravenous anticancer drugs. The medical decision is thus subject to the financial gain or loss that unequivocally will affect the prescribing physician. Myeloma patients are treated with sequential oral regimens, mostly in combination with dexamethasone. Not necessarily a best practice.”

Truth in Numbers

In a letter to the editor published at The News & Observer, Robert Zirkelbach sets the record straight on what’s driving the rising cost of health care.

“No patient should have to worry about whether they can afford the health care they need,” Zirkelbach argues. “However, the notion that spending on medicines is the primary driver of health care cost growth is false and ignores cost savings that medicines provide to the health care system overall.”

  • Nationwide, spending on prescription medicines accounts for approximately 14 percent of all health care spending.
  • In North Carolina, retail prescription medicines accounted for just 5.4 percent of overall Medicaid spending in 2014.

2016 Candidates on Health Care: Donald Trump

The biggest critics of 2016 GOP presidential candidate Donald Trump’s health care platform are Republican policy experts. The New York Times’ Robert Peat and Maggie Haberman write that “Donald Trump’s Health Care Ideas Bewilder Republican Experts.”

“He has to discard some of his ideas, like the importation of prescription drugs, because they would be damaging and unworkable,” Grace-Marie Turner, the president of the Galen Institute, which supports free-market health policy, told the New York Times. “And he has to flesh out his other proposals with much more detail if he hopes to persuade voters that he has a credible plan to replace Obamacare.”

As with other major policy areas, Trump hasn’t named the people that are advising him on health care. Trump policy adviser Sam Clovis says at least half a dozen “very prominent people” are providing input on health care.

“They are not ready to have their support of the Trump campaign known,” Clovis said.

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