For anyone who believes that health care, in the wealthiest nation in the world, is a right and not a privilege, the Biden Administration provided some cause for optimism. It came in the form of an announcement by Vice President Kamala Harris that the nation will invest $1.5 billion to help reduce the shortage of doctors and nurses in underserved communities.
Working with sums provided by the spring’s American Recovery Act, the White House said it will boost financial support for medical workers participating in the National Health Service Corps and Nurse Corps.
They provide services to more than 23.6 million patients in this country, the White House said.
The corps, founded in 1972 in response to the shrinking supplies of vital primary care providers, helps participants with four loan repayment programs for medical, dental, and mental health professionals, the Washington Post reported, adding:
“In exchange for two to three years of work at an approved site, participants can receive up to $100,000 in loan forgiveness, depending on the line of service. Scholarships are also available for students willing to commit a minimum of two years in exchange for a full year of funding. Participation and funding have increased over the years, but demand in some programs has outpaced the money available to support them. An audit released in June by the Government Accountability Office found 43% of the more than 11,100 providers who applied to programs did not receive funding in fiscal 2020. While some applicants were simply ineligible, others were rejected because the limited funds are prioritized for those serving in areas with the most severe shortages.”
Harris said advisors underscored for the White House that the coronavirus pandemic worsened and made even more prominent disparities in the U.S. health care system, on which Americans spend almost 18% of the nation’s gross domestic product. Big sections of the country — communities of color, poor parts, and rural areas — already experience major problems in attracting medical providers, the doctors and nurses who give front-line care to the sick and injured, as well as preventive services to children, the elderly, and the chronically ill or mentally ill.
The pandemic has not only savaged people in underserved communities, sickening and killing disproportionate numbers of black, Latino, older, and rural residents, it has overwhelmed health care systems in these areas.
The $1.5 billion will allow the health corps to increase its participants to 23,000 from 16,000 clinicians, which the White House said will be the largest number in the program ever.
With these anticipated shortfalls, medical educators are expressing guarded optimism about a surge of interest in health careers among young people, fueled by admiration for the hard, brave work of medical professionals in battling the pandemic. Medical schools have reported an 18% increase in 2021 applicants, while public health graduate programs have seen a 40% spike in year-over-year in applications. Programs preparing registered nurses (RNs) with bachelor’s degrees have seen enrollment increases of 5.6%.
Still, the costs of launching medical careers, especially for aspiring doctors, can be formidable. Experts say $330,000 is the median cost for four years of study to become a U.S. medical doctor in private schools (vs. $250,222 in public institutions). Class of 2020 graduates left medical school with an average education debt load of $207,000.
Aspiring doctors or nurses who come from communities of color, who are poorer, and those who hail from rural areas may be unable to take on the financial burdens of their medical education, creating inequities in professional representation reflected by official data. As the Washington Post reported:
“According to the Association of American Medical Colleges, about 17% of doctors in the United States are Asian, 6% are Latino, 5% are black, and less than 1% are American Indian and Alaska Native.”
Harris had this observation of this challenge, the newspaper reported:
“Our nation must invest in a health care workforce that looks like America and provide access to equitable health care for all Americans. There is more work to be done, but I believe we are headed in the right direction.”
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent health care. This has become an ordeal due to the skyrocketing complexity, uncertainty, and cost of therapies and prescription medications, too many of which turn out to be dangerous drugs.
Confronted with these formidable obstacles to excellent care, patients also should not hit shortages of providers or a dearth of medical pros who by benefit of their lived experience may provide them with improved medical services. We have work to do to ensure that health care is equitable and accessible as a safe, affordable right for all.