Mind the Gap

Why Congress Needs to Invest $3 Million in U.S. Health Workforce Planning

Ensuring a wide array of health care professionals working where they are most needed is a key element in health care reform. Without more diverse and well-distributed groups of primary care doctors and specialists, nurses, dentists, and other assistants and technicians, there can be no real reforms. But partisan budget fights in Congress are hindering efforts to tackle national workforce planning, and ignore the need to assess and address issues such as the shortage of primary care doctors, the regional maldistribution of health professionals, the overspecialization of physicians, and the need for a diverse and culturally competent workforce.

These health care workforce gaps are real and growing. They must be addressed regardless of the reforms being implemented. America’s 5 million health care professionals labor every day to care for their patients and they directly influence the cost and quality of health care through their diagnoses, orders, prescriptions, treatment, and preventive services. As the 78 million baby boomers begin to hit retirement age, and the nation looks forward to the expansion of health care coverage to all Americans, there are very real concerns that we do not have an adequate health care workforce to address the growing needs. That is certainly already true for those Americans who live in medically underserved areas.

Moreover, there must be a national effort to ensure appropriate education and training of up-and-coming health care professionals. Why? Because experts across the political spectrum recognize that health care services need to be more focused on prevention, the better management of chronic conditions, and a multidisciplinary team approach to delivering integrated physical and behavioral care.

All these reasons are why the Affordable Care Act created a National Health Care Workforce Commission. It takes more than a decade to train a doctor, which is why the commission is charged with looking at the national needs out into the future, as much as 25 years ahead. This expert body will:

  • Serve as a national resource for Congress, the president, and states and localities
  • Communicate and coordinate with federal departments
  • Develop and commission evaluations of education and training activities
  • Identify barriers to improved coordination at the federal, state, and local levels, and recommend ways to address them
  • Encourage innovations that address population needs and changing technologies

The 15 members of the commission were appointed by the Government Accountability Office in September 2010. The first report was due in April. But they have not been able to undertake any activities—not even to convene, converse, or hire staff—because the money needed to do this has not been appropriated.

At issue here is $3 million for important planning and oversight work that used to enjoy bipartisan support. This is a trivial sum compared to the federal funding provided for health care workforce development, which currently amounts to $12 billion per year through Medicare and Medicaid, and $530 million through the Health Resources and Services Administration. Now it is held hostage to conservative demands over the budget and their disdain for health care reforms. Having voted to repeal the entire Affordable Care Act, the Republican-led House majority is now pushing to include in the budget a requirement that no taxpayer dollars will be directed to fund the new law.

What’s more, the House repeal efforts would also abolish or defund other key strategies for addressing impending health workforce shortages such as scholarship programs for medical students to train in primary care and work in underserved areas, and financial incentives for these primary care providers. A Center for American Progress report by Daniel Derksen and Ellen-Marie Whelan highlights how a National Health Care Workforce Commission can ensure our nation’s investment in the education and distribution of health professionals is a public good, of the highest quality, and accountable for better performance on clear and measurable outcomes.

It’s time for lawmakers to support this critical work.

Lesley Russell is a Senior Fellow at the Center for American Progress focusing on health care issues.