President Obama's ambitious plants to expand health care for millions of currently uninsured Americans while simultaneously meeting the needs of aging boomers, may be stymied not only by politics-as-usual but a shortage of primary care physicians, the New York Times reports. Officials are weighing several options, including increasing Medicare payments to general practitioners at the expense of specialists—a proposal that has, predictably, triggered a lobbying showdown between groups of doctors.
Increasing the overall supply of doctors would increase access to care but would frustrate cost-curbing efforts, and increasing payouts to primary care doctors at the expense of specialists could reduce the number of specialists, especially in rural areas. Officials are also considering increasing enrollment in medical residencies, relying more heavily on nurse practitioners, and expanding the National Health Service Corps.
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