When The Best Hospitals Are The Worst

James Hamblin | The Atlantic | July 1, 2013

If you had $13 billion to train doctors, how would you spend it?

Assume we successfully get health insurance for 32 million more Americans. Not a single person "falls through the cracks." Every aspect of Obamacare launches and integrates perfectly. The exchange websites are beautiful and intuitive; every state with gaps conjures an elegant fix. There's a quantifiable change in barometric pressure as the nation collectively sighs.

The moment would be fleeting. Panic resumes when the newly insured try to get appointments to see doctors. Overbooked, miles away, or otherwise inaccessible; what does it mean to be able to afford care if no one is there to provide it? Within the decade, the U.S. physician shortage will be around 91,500, with about half of them in primary care. Already today, 60 million Americans live in federally designated primary care shortage areas.

That's the picture painted by demographer and senior research fellow with the New America Foundation Phillip Longman in the current issue of Washington Monthly, where he takes a thoughtful at look at how federal dollars spent training physicians are distributed.