The creation of a national planning body to assess and make recommendations about important health care workforce issues was first officially recommended in 2008 by the Council on Graduate Medical Education 19th Report, a Journal of the American Medical Association editorial, and the Association of Academic Health Centers.
A permanent National Health Workforce Commission would make recommendations to Congress and appropriate government agencies to design funding and incentives, and to evaluate the implementation and revision of programs, grants, and regulations related to the nation’s health workforce. Because demand for health care services changes and the health workforce training lasts many years, a permanent commission could regularly evaluate federal funding of health professional education and graduate distribution to areas of need, and make recommendations to improve outcomes.
The most important issue our proposed commission would evaluate is federal spending on residency programs. The $12 billion spent in teaching hospitals is not consistent with where Americans receive their health care or current workforce needs. While there is general recognition that the reinvigoration of primary care is the basis of meaningful health care reform, these monies reinforce a specialty driven health care system.
Moreover, this money is not actively managed by the government. The funding formulas to support health professions education are complex, inconsistently evaluated, and often unfairly distributed to states. The health care institutions receiving subsidies for health professions education should be required to annually report on their performance and outcomes, be independently evaluated, and be held more accountable for meeting the
Both the Senate Workforce Commission and the House Committee on Health Workforce would be comprised of 15 members representing a broad range of health workforce stakeholders. Data, analysis, and recommendations could be compiled and analyzed from the various nursing, physician, and dental health workforce committees. The commission in the Senate bill however is preferable because its design would help protect it from political interference.
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