Sen. Bernie Sanders (D-Vt.) said it’s obvious America has a problem when it comes to health care.
“Simply put ... a significant percentage of our population live in places where they cannot access the health care they desperately need,” Sanders said as he opened a hearing by the Senate Health, Education, Labor and Pensions (HELP) committee on Feb. 16.
Sanders chairs the committee, which was convened to hear from experts in the health care industry about the critical shortage of doctors, nurses, and other health care professionals. The experts said the shortage was bad before the CCP (Chinese Communist Party) virus—commonly known as the novel coronavirus—but the pandemic had exacerbated it.
According to Sanders, the committee was tasked with helping solve the problem, but at least one committee member said better solutions might be found elsewhere.
“I wouldn’t look to this place [the U.S. Senate],” said Sen. Mike Braun (R-Ind.) told the witnesses who testified before the committee.
Sanders opened the hearing by laying out the problem. He said 100 million Americans do not have access to adequate primary care. Nearly 70 million cannot get adequate dental care, and 158 million have inadequate access to mental health care.
Sanders said this is so even as America spends almost $13,000 on health care “for every man, woman, and child” in the country. According to Sanders, this is twice what other countries spend. Still, he said America doesn’t appear to have enough doctors.
He told the committee that there would be a shortage of over 120,000 doctors over the next decade. Within the next two years, the country will need up to 450,000 nurses; today, America needs more than 100,000 dentists.
“And in America today, there is a massive shortage—many, many hundreds of thousands—of mental health service providers,” Sanders said.
This includes psychiatrists, psychologists, social workers, counselors, addiction specialists, and others, he said.
Testifying before the committee was James Herbert, president of the University of New England in Biddeford, Maine; Dr. James E.K. Hildreth Sr., president and CEO of Meharry Medical College, Nashville, Tennessee; Dr. Sarah Szanton, dean of the Johns Hopkins University School of Nursing in Baltimore, Maryland; Dr. Leonardo Seoane, Chief Academic Officer, Ochsner Health, New Orleans, Louisiana; and Douglas Staiger, economics professor, Dartmouth College, Hanover, New Hampshire.
The experts told the committee that the shortage was due to various factors. The said low pay, high stress, heavy workloads, and general burnout drives many from the health care industry. The pandemic seemed to aggravate that problem, with nurses reporting more instances of verbal and physical abuse on the job.
Sen. Tammy Baldwin (D-Wis.) said proposed legislation would make violence, including verbal abuse, against a health care professional a felony.
“Violence against health care workers is totally unacceptable.”
But the witnesses said that people leaving the industry is only part of the problem. A more significant issue is trying to find their replacements.
Hildreth heads the historically black Meharry Medical College in Nashville, Tennessee. He said the school has partnered with local middle and high schools to recruit black students into the health care field.
According to Hildreth, students are more likely to consider the profession if they have role models who share their culture. This translates into better health outcomes when health care professionals serve the communities from which they came. Hildreth said Meharry graduates follow that lead.
“I’m proud to say that 80 percent of our graduates go on to serve the underserved,” Hildreth said.
One common problem is training new doctors, nurses, and others. Szanton said the average nurse is 54 years old, with many nurses working past age 60. In his opening remarks, Sanders said the average nursing school instructor makes about $65,000 annually. This is less than a nurse in a hospital can make. As a result, many nursing school applicants are turned away because there is no one to teach them.
Staiger, an economist, said that there isn’t really a shortage when it comes to nursing. The larger problems are that nurses are bucking the trend and leaving hospitals for rural areas where the pay and working conditions are better. And, fewer new nurses are being made because there is no one to teach them. Seoane said his organization’s experience bears out Staiger’s claims.
“We currently have 1,200 open nursing posts throughout our system,” he said.
Szanton said passage of the Future Advancement of Academic Nursing (FAAN) Act, introduced in the last Congress, would go a long way toward solving these problems.
The FAAN Act would authorize the Health Resources and Services Administration to award grants to nursing schools to increase their capacity to respond to enhance nursing education programs. According to information on the U.S. Senate webpage, the FAAN Act would prioritize programs at HBCUs and other minority-serving schools in underserved communities.
Hildreth said his school, like other historically black colleges and universities (HBCUs), have not been able to update its infrastructure. He told the committee they would need about $5 billion over the next five years to update their classrooms, labs, and other facilities, in addition to staff, to prepare their students for the future health care industry.
Two Republican Senators in the community acknowledged the problems facing the health care industry. But, they said there might be better solutions than the government money.
Sen. Mitt Romney (R-Utah) said the U.S. has a potential gold mine of doctors and nurses waiting to go to work. According to Romney, immigration officials staying home from work over COVID-19 concerns need to begin processing applications for foreign-born doctors and nurses.
“The right answer is not more government,” Romney said. “Our government is just not doing the interviews.”
Sen. Mike Braun (R-Ind.) said the health care industry had everything it needed to solve the problems. Considering the country’s financial state, Braun said government spending would only worsen the situation over the long run.
“We not going to solve anything by borrowing from our kids and grandkids,” he said. “I wouldn’t look to this place (the Senate).”
Based on his business experience, Braun said the medical industry is “top heavy.” He said insurance companies, which he called the “Darth Vader of the industry,” had too much control over costs. Braun said his company was able to self-insure and, as a result, paid less than it did with traditional insurance without any year-to-year rate increases.
He said free market, entrepreneurial principles should be employed, such as partnering with public schools to promote the health care field as a valid career choice. Seoane and Hildreth said their organizations are working with their local schools. But Seoane said the challenge is much larger than that. He pointed out that Ochsner is involved in apprenticeships and other programs in their schools.
“But to scale them, we need support from our universities; we need support from our community colleges; we need support from our governments. I do think it’s a partnership,” Seoane said.
Hildreth added that a change of mind might be needed as well. He said our health care system is a “sick” care system focused on treating illness rather than promoting health.
“If we took that $4.3 trillion we spend on the sick and reduced that 10 percent, we would have $400 billion to invest in public health, and that’s exactly what we should be going in my humble opinion,” he said.
