Recently I read a headline about the U.S. adding 1,000 new doctors. Behind that headline is a bigger story about why we need universal health care.
To be a licensed doctor you have to complete training after medical school called residency. In our country, the Centers for Medicaid and Medicare Services pays for residency. For decades there has been a cap on residency slots. President Biden raised the cap, which is good, but it also means that our doctor “shortage” is artificial. We could have more doctors anytime we want.
It’s the latest time in the pandemic that I thought this kind of problem wouldn’t exist if we had universal health care. Insurance companies wouldn’t have the power to tell us how many doctors we can have.
People have been laid off because of the pandemic. Tying health insurance to employment is a cruel gamble at the best of times and makes no sense during a public health crisis.
You’ve heard the phrase “talk to your doctor.” Most people can’t do that in our health care system. Insurance companies call it having a Primary Care Provider (PCP). Even if your plan requires you to pick one it doesn’t mean you have the kind of relationship where you know that you’ll get reliable advice simply by calling their office. I don’t say this as an attack on anyone caring for patients, but we’ve built a system where being brushed off is a feature, not a bug.
Not everyone has health insurance. Fewer Black Americans have health insurance than white Americans and we don’t distribute resources equally. Because we’re so segregated you’re more likely to have PCP offices and mental health doctors located in white or affluent neighborhoods, according to The Century Foundation’s 2019 report about racial inequality in health care. I’d argue you can see this on Genesee Street. The further south you go from center city, the more mental health providers and doctors’ offices there are, with community providers mostly downtown.
Living through the pandemic can change how we think about health care in our country.