The free market system just doesn’t work for health care. If it did, we would sell kidneys at auction to the highest bidder instead of having a waiting list of those most in need.
Unfortunately, we have convinced ourselves that the power of the free market holds the solution to all of our problems. When public schools fail, we don’t increase funding, we shift it to private schools. But almost nobody supports auctioning off kidneys.
And so we’ve got a conundrum. With Medicaid, Medicare and the Affordable Care Act, we have created a hybrid, patchwork system that provides a safety net for some – the very poor and the elderly – but leaves millions of families to fend for themselves.
New Mexico is a prime example of how the system has not worked. We were one of the first states to adopt the ACA, and brought scores of previously uninsured residents into the system, just as intended.
But we have not provided the necessary incentives under the free market system to lure and retain health care professionals, leading to a dangerous shortage. We lost 30 percent of our primary care physicians in the five years from 2017 through 2021, according to a study by the New Mexico Health Care Workforce Committee.
The number of ob-gyns, registered nurses, dentists, psychiatrists, pharmacists and EMTs are also seeing similar declines. And things will only get worse unless action is taken now. Nearly 40 percent of all doctors in this state are 60 or older, with plans to retire soon.
The Santa Fe-based public policy group Think New Mexico has a package of legislation for the upcoming 60-day session that starts in January to reverse the trend. It includes tort reform, which is always a tough sell in a state legislature filled with attorneys looking out for their own interests. New Mexico has the second-highest rate of medical malpractice suits per capita in the nation, according to information provided by Think New Mexico. That’s worked out great for the lawyers, but not so much for the rest of us.
Other proposals include joining interstate health care worker compacts, creating a centralized credentialing system for health care providers, making it easier for patients to keep their current provider when they change insurance, improving the student loan repayment program for health care providers, repealing the gross receipts tax on medical services, enhancing Medicaid reimbursement rates to providers, expanding access for high school students to train for health care jobs, increased funding for college health care education, making it easier for foreign doctors to receive provisional licenses and creating a $2 billion permanent fund for health care.
Assuming legislation is introduced on each proposal, the Legislative Finance Committee will then prepare a fiscal impact report on each bill, complete with the expected cost. I suspect when you add them all up, the total will be staggering.
They could start with tort reform, which wouldn’t cost taxpayers a dime. Then they should prioritize funding for solutions that will bring the most immediate results.
I think the obvious solution is universal health care. But as long as we’re stuck with this free market hybrid, the state must compete to attract the health care workers we need. Hopefully, the Think New Mexico report will focus the attention of lawmakers to address the problem before the shortage leaves more residents in our state without access to care.
Walter Rubel can be reached at waltrubel@gmail.com.
