ELIMINATE MEDICAL DESERTS
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Happy Monday Advocates
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Provide Healthcare Where Needed
Today I want to address legislation that really aims to help people.
Burnout, lower pay, high stress work in medical factories (networks that demand high patient load), and the COVID-19 pandemic are all contributors to medical professionals finding other employment.
This pressure cooker environment has real world consequences for so many of us, especially if you happen to live in a rural area (20% of us) or in a medical desert where care is just hard to reach.
According to a GoodRx study using US Health Resource Services Administration data, about 9% of the population lives where there is one doctor for more than 10,000 people, a medical desert. That’s more than three times the normal case load. The darker the color the larger percent of the county without a doctor. If you go to this link the chart above is interactive and you can see that so many of the counties have no doctors at all.
According to the most recent estimates, over the next decade the United States faces a shortage of over 120,000 doctors — including a huge shortage of primary care doctors. The nursing shortage may be even worse. Over the next two years alone, it is estimated that we will need between 200,000 and 450,000 more nurses.
Sen. Bernie Sanders (I-Vt.), Chairman of the Senate, Health, Education, Labor, and Pensions (HELP) Committee, and Sen. Roger Marshall, M.D. (R-Kan.), Ranking Member of the Subcommittee on Primary Health and Retirement Security, announced last week that they have reached a deal on landmark legislation to address the primary care crisis in America and the major shortages of nurses, primary care doctors, and other important health care jobs across the country, and to increase critical funding for community health centers, the National Health Service Corps, and Teaching Health Centers.
Here is a link from C-Span to see Senator Sanders introduce the bill.
This bill will be marked up on the 21st of September. Here is what is proposed:
The Sanders-Marshall agreement answers this crisis by providing over $26 billion in funding to expand primary care in America and address the health care workforce shortage:
Provides $5.8 billion a year over the next three years in mandatory funding for community health centers which provide high-quality primary health care to more than 30 million Americans.
$245 million per year set aside to expand hours of operation at community health centers and $55 million per year for school-based health services.
Health centers will be newly required to provide nutrition services.
Provides $3 billion in capital funding primarily to enable community health centers to expand dental care and mental health care in their facilities.
Increases funding for the National Health Service Corps from $310 million to $950 million per year over the next three years to provide 2,100 scholarships and debt forgiveness for some 20,000 doctors, nurses, dentists, mental health providers, and other health care professionals who commit to working in our nation’s most underserved areas.
Provides $1.5 billion over the next five years in the Teaching Health Center Graduate Medical Education program to create more than 700 new primary care residency slots, which would result in up to 2,800 additional doctors by 2031.
Addresses the nursing shortage in America by investing $1.2 billion in grants to community colleges and state universities to increase the number of students enrolled in accredited, two-year registered nursing programs. This will allow schools to train up to 60,000 additional two-year nurses.
Provides $300 million to produce an additional 2,000 primary care doctors by 2032.
The bill will also increase residency programs in rural America through an investment in the Rural Residency Planning and Development program and invests in training and workforce programs for dentists and dental assistants.
The bill can be largely paid for by eliminating waste, fraud and abuse like that performed by pharmacy benefit managers.
This bill trains and makes more doctors and nurses available, builds out facilities to provide more care and will help fill the gap that looms before us.
ACTION
Let’s let our Senators and Representatives know we want them to support this legislation. Here is their contact info.
Here is a sample script - you can send it via RESISTBOT from your cell phone by texting SIGN PEJGSU to 50409.
“I am your constituent, [name], in [zipcode].
I understand that Senator Sanders and Senator Marshall M. D. have reached a deal on landmark legislation to address the primary care crisis in America. It addresses the major shortages of nurses, primary care doctors, and other important health care jobs across the country. It will increase critical funding for community health centers, the National Health Service Corps, and Teaching Health Centers. It will be marked up this week and I want you to cosponsor it and actively work to support it. It will help make sure that we eliminate the medical deserts that 30 million of us live in. Thank you.”
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
https://www.commoncause.org/find-your-representative/addr/
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Plan
Reproductive Health
NARAL - Pro Choice America
Charley. NARAL’s abortion resource
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
As a retired nurse educator, I can attest this is a necessary step in the right direction.
However, a huge issue remains - about 30% of new graduate nurses will leave the profession entirely within their first 3 years. (This was accurate in 2019, not sure what stats say now, but I imagine it is similar.) Working conditions and structural work-related supports for new nurses are also important to prevent the attrition of new grads.
Also my daughter is an internal medicine doctor first year out of residency. Her husband is a fellow in pediatric psychiatry.
Both great, but they have over 500,000 in student loan debt.
Also both post pandemic medical traumatized! Really, covid was very tough on them mentally and physically.
Not sure how you encourage primary care with such significant debt.