Vice Chair Crowley Testimony Before the Ways & Means Committee on the Need to Address Looming Doctor Shortage

June 8, 2016
Press Release

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(Washington, D.C.) – Today, Rep. Joe Crowley (D-Queens, the Bronx), Vice Chair of the Democratic Caucus, testified before the House Ways and Means Committee’s Subcommittee on Health on the need to address the looming doctor shortage and ensure access to care. The hearing, titled “Legislation to Improve and Sustain the Medicare Program,” reviewed members’ proposed legislation to strengthen the Medicare system. Crowley is the author of the Resident Physician Shortage Reduction Act (H.R. 2124), legislation that addresses the looming doctor shortage by expanding the current cap on the number of Medicare-supported residency training slots for doctors, helping to ensure teaching hospitals can meet the growing needs for more physicians. Over 125 bipartisan members of Congress have signed on to cosponsor the bill.

Below are his remarks as prepared for delivery:

“Thank you Chairman Tiberi and Ranking Member McDermott, for this opportunity to join you today as we hear proposals to strengthen the Medicare program.

“I’m glad to have the opportunity to talk about legislation I’ve put forward to address what must be a priority within the Medicare program – training the doctors we need to meet the health care needs of tomorrow. This is not something we can take lightly.

“Estimates indicate that by 2025, we’ll have a shortage of up to about 95,000 doctors, both primary care doctors and specialists. Our health care needs are only growing – with a greater importance on preventive care and comprehensive health, and an aging population. Ten thousand Americans turn 65 every day. So it is clear we need to have doctors available to treat them and Americans of all ages.

“Important steps have been taken. Medical schools have worked to increase their enrollment and their graduating classes. But what a lot of people don’t realize, is that once those students graduate, they need to complete another stage of training, by doing a residency program at one of the nation’s teaching hospitals. Without completing their residency, they cannot become licensed to practice medicine.

“Unfortunately, growing numbers of smart, well-prepared medical school graduates are fighting for a stagnant number of residency slots. We’re not just facing a physician shortage – we’re facing a physician bottleneck.

“But there is a clear path forward. For generations, training doctors has been a shared responsibility of the federal government and teaching hospitals. And that’s because it is a shared benefit – the whole country benefits from more well-trained doctors.

“Congress has long recognized the value of investing in doctor training, and as a result the Medicare program helps to support doctor training programs by funding residency slots around the country. However, there is an arbitrary cap on the number of residency slots that Medicare will support, and this cap hasn’t been raised in nearly two decades.

“Teaching hospitals have done their part in stretching their funds as far as they can go, to help fund additional residency positions even beyond what Medicare covers. But they cannot do it alone.

“We must act, and act soon, to raise the Medicare cap on residency slots. There’s no way to create more doctors overnight, but we can make the changes now, that will open up the doctor training pipeline.

“I’ve put forward bipartisan, common-sense legislation, the Resident Physician Shortage Reduction Act, to increase the number of Medicare-supported residency slots by 15,000 over 5 years.

“I’m pleased to have been joined in this effort by Dr. Charles Boustany, a member of this committee and someone I think all of us respect for his experience – after all, who better to help stress the importance of medical training than a cardiovascular surgeon?

“Over 125 members of the House, including many members of this committee, have joined us as cosponsors of this bill.

“This bill would further address our doctor shortage issues by directing half of the new slots to go to specialties that are determined to be running a shortage. And, it makes a definitive statement that we need to make a strong investment in our doctor training programs.

“That is particularly important should we see continued proposals to cut or weaken the impact of graduate medical education funding.

“Far from being a luxury, teaching hospitals depend on this funding to fulfill their mission. It is an investment – not just in the dollars and cents of running a teaching hospital. But in the highly complex, and costly, patient care missions that teaching hospitals undertake. They run advanced trauma centers and burn units, they see more complex patient cases, they treat patients with rare and difficult diseases like Ebola. And that helps train future doctors in all those areas.

“Graduate medical education payments were designed by Congress to reflect – and encourage, and reward – all those efforts. And in a time of changing health care, teaching hospitals are doing more to train residents in community care settings and to give residents the skills to provide exactly the kind of coordinated care that our system is moving toward.

“So I urge all my colleagues on the committee to allow our teaching hospitals to continue to thrive in their mission of training the next generation of physicians. That means maintaining our investment in graduate medical education funding. And, in what I hope will be a priority for this committee, it means lifting the outdated cap on residency slots.

“It’s not exaggerating to say the future of our health care system depends on it.”