Speeches & Floor Statements

Hearing Statement: Addressing Shortages and Improving Care

Posted on May 22, 2018

  • The Senate Committee on Health, Education, Labor and Pensions will please come to order.

Senator Murray and I will each have an opening statement, and then we will introduce the witnesses.

After the witnesses' testimony, senators will each have 5 minutes of questions.

Today’s hearing is an opportunity to:

Learn about the growing shortage of health care professionals – especially in rural areas

Examine what the federal government is doing to support our nation’s health care workforce

Look at how well we are training health care professionals to meet the needs of patients, and

Better understand where health care professionals are choosing to work so we can start addressing shortages in rural and urban areas of the country. I hear often from doctors and patients in Tennessee about the shortage of health care professionals, and from members of this committee.

We know that the shortage of health care professionals – which includes doctors, nurses, paramedics, and x-ray technicians – is a problem that has the potential to keep getting worse.

First, our country’s population is aging and growing – which is widening the gap between the number of people who need health care and the number of those who provide it.

According to the Association of American Medical Colleges, by 2030, our total population is expected to increase by more than 10 percent and the percentage of people over 65 is expected to increase 50 percent compared to today.

Second, at a time when we need more health care professionals, many of the existing health care workforce will reach retirement age.

A third of all doctors will be older than 65 in the next ten years according to Association of American Medical Colleges.

Simply put, we may have too many people and too few medical professionals.

We also know that rural areas where 60 million Americans live suffer the greatest impact of the shortage of health care professionals.

According to the National Rural Health Association, there are only 39 primary care doctors for every 100,000 people living in rural areas, but there are 53 primary care doctors for every 100,000 people in urban areas.

That difference is even more dramatic for anesthesiologists, neurologists, cardiologists, and other specialists – urban areas have 263 specialists for every 100,000 people, but in rural areas there are only 30 specialists for every 100,000 people.We also know the shortage affects certain populations more than others.

For example, in 2014, the American Congress of Obstetricians and Gynecologists reported that 47 rural Tennessee counties, out of 95 total, had no OB-GYN.

That means a young couple starting a family may have to travel to Memphis, Nashville or Knoxville to see an OB-GYN.

And, older Americans could face shortages in the coming years because there are not enough health care workers trained to care for geriatric patients.  The Bureau of Labor Statistics has estimated that by 2024 we will need 1.1 million more nursing aides, home health aides, and other health workers to assist older patients.


What the Federal Government is Doing:

The federal government is currently doing three things to help reduce and prevent shortages of health care workers.

First, about $10 billion goes to Medicare Graduate Medical Education Programs, which funds resident training for new doctors. That program is in the jurisdiction of the Finance committee.

Second, we spend over $1 billion on about 70 different health workforce programs that provide scholarships and loan repayment for students, faculty, and health care professionals in exchange for working in rural areas.  These programs also provide grants for children’s hospitals that train new doctors and dentists.   All of these programs are within the HELP committee’s jurisdiction, and we need to better understand if they are actually working and if they need to be changed.

And finally, we spend about $310 million for the National Health Service Corps, which provides loan repayment for primary care doctors who go to work in underserved areas.  Most of these doctors choose to work at the 10,000 community health centers across the country.


Going Forward:

We need to know if what the federal government currently is doing is effective or if specific improvements should be made?

Do we need all of these programs, or should there be changes to better meet the needs of patients?

The witnesses here today will also be able to help us better understand how well we are training health care professionals, and what we can do to encourage more people to enter the health care workforce as professionals retire.

I also plan to ask our witnesses today what role the federal government can play in encouraging health care professionals to work in underserved and rural areas of the country where they are most needed.

I look forward to hearing their recommendations, and it is my hope that the committee will soon begin working on solutions to address these shortages.