Texas will need more plans for health care
Demand has been artificially suppressed because of the state’s top-ranked uninsured rate. According to the Centers for Disease Control, nearly 32 percent of non-elderly Texas adults were uninsured in 2009. They generally only see a physician when they have to.By 2014, the Affordable Care Act will change that. Expanded Medicaid, insurance exchanges and the individual mandate are expected to push the state’s uninsured rate well below 10 percent. That is the good news.
The bad news: Health care will be rationed based on the ability to get onto a doctor’s calendar and to wait patiently for an appointment In 2020, the number of residents with Texas health insurance will grow by 50 percent, or about 9 million people. The Austin-based Center for Public Policy Priorities estimates that the Affordable Care Act will insure about 4.5 million more Texans. The state demographer projects Texas will grow by about 5 million residents in this decade. At least 90 percent, or another 4.5 million, will also be insured.
The population will be older and sicker. More than 97 percent of the demographer’s population-growth estimate is among minority groups. The youngest baby boomers turn 50 in 2014, an age beyond which about 80 percent have at least one chronic condition.
As the numbers grow, there will not be enough doctors and nurses. Nearly 40 percent of doctors are 55 or older. Nearly 22 percent of Texas physicians will reach retirement age in the next five years. About one-third of nurses are 50 or older, and more than half of those want to retire before 2020 – creating a shortage of 71,000 in Texas. Health economist Peter Buerhaus predicts a national shortage of 100,000 physicians and 300,000 nurses by 2020.
Texas has 212 physicians per 100,000 residents. The rate has been stable because the 2003 medical malpractice reforms have attracted thousands of out-of-state doctors. That has allowed the state to keep up with population growth. That will be insufficient in the future.
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