Shalala: Health Revamp May Mean Doctor Shortage

Donna Shalala i i

hide captionDonna Shalala, shown here in 2007, served as secretary of the Department of Health and Human Services in the Clinton administration.

Stephanie Kuykendal/Getty Images
Donna Shalala

Donna Shalala, shown here in 2007, served as secretary of the Department of Health and Human Services in the Clinton administration.

Stephanie Kuykendal/Getty Images

As legislators continue to work on an overhaul for the U.S. health care system, numerous questions linger. Here's one of them: If millions more Americans get health insurance, will there be enough doctors to handle the increase in patients?

Donna Shalala, secretary of the Department of Health and Human Services in the Clinton administration, says right now, the answer is no.

"The shortage is related to primary care," Shalala tells NPR's Scott Simon. "We have lots of specialists in the country. We'll need more primary care physicians."

Shalala, now president of the University of Miami, says there will be opportunities for nurses to take on a larger role in offering primary care.

"With all the advanced-practice nurses that we have in this country and more to be trained, there is a special role for nurses in our expansion of health care for all," she says.

Shalala says she has visited Washington to talk with people "deeply involved" in revamping health care policy, many of whom she worked with on the same issue in the Clinton administration. During that time, she oversaw Medicare and Medicaid, and she believes that, at least with Medicare, there are clear ways to cut overall costs.

"Drug costs are much too high in the Medicare program compared to the real costs that a large program ought to be paying," she said. "And there certainly is fraud in the system that we ought to simply get out."

Shalala says the Clinton administration worked hard to combat fraud in the Medicare system. Still, she says, some of the problems are locked into the legislation, specifically the way health care is paid for.

"Fundamentally, we have to stop paying on the basis of volume," she says. "We have to straighten this out. We've got to pay on the basis of value, on the basis of making sure people stay healthy."

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