It means nothing to have health insurance if it doesn't come with a doctor.
When Gov. Tom Corbett unveiled his Healthy Pennsylvania alternative to Medicaid expansion in September, attention focused on his proposal to use federal dollars to allow eligible citizens to buy health insurance through the private market, rather than expand Medicaid to cover 1-in-4 Pennsylvanians.
That's worth debating, but it misses the larger picture.
Right now, whether it is through Healthy Pennsylvania or Obamacare, we are about to expand the universe of eligible people seeking medical care by a half-million — and we don't have the doctors to meet the demand. In fact, by 2020, studies estimate the United States will face a doctor shortage of 92,000.
As Dr. Bruce McLeod, president of the Pennsylvania Medical Society warned:
"We can't just turn a spigot and suddenly we're going to have a bunch more primary care physicians pop out. It doesn't work that fast."
This is where the Corbett proposal makes sense. "Healthy Pennsylvania" doesn't merely address health insurance — it addresses the actual health care.
Already, the governor has provided $4 million to build new and expanded, community-based, primary care health clinics around the state. The plan he submitted to the federal government would seek to access funding for more of these clinics.
But those clinics will need doctors, sometimes specialists.
Corbett's proposal would promote loan forgiveness to encourage new doctors to establish practices in rural and under-served communities around the state.
Until the medical community can educate and train the next generation of doctors and specialists to handle the expanding caseload that will result from increased medical coverage, we must get maximum productivity from the existing pool of doctors and specialists.
Again, the Corbett plan appears ready to address that challenge.
The governor's proposal would expand the use of tele-medicine and other forms of technology driven communications, allowing for a real-time exchange of information and data between practitioners in every corner of the commonwealth and the specialists who tend to base themselves in population centers. In short, a small town in Potter County might not have, say, a medical geneticist — but somewhere in the state or nation, a clinic is bound to have one.
This connects the specific needs of a patient with the unique talents of every doctor with a computer and phone line.
These details of the governor's Healthy Pennsylvania plan deserve more attention and a little more enthusiasm.
Corbett's plan isn't simply about health insurance: it's about health care. That, alone, tells me the Pennsylvania solution to health coverage has given thought to more than numbers. It has thought about every single patient now and in years ahead.
As a doctor, I think that's something worth sharing.
— Rad M. Agrawal is a senior attending physician in the Division of Gastroenterology, Hematology and Nutrition at Allegheny General Hospital in Pittsburgh.