How California can stay healthy
California’s population is aging. Without big changes in how the state finds and trains its health care workforce, it soon won’t have enough physicians and other caretakers to look after its people.
That’s the message from a startling new report by the California Future Health Workforce Commission.
The commission, a coalition of CEOs, educators, nurses and physicians who spent nearly two years studying the challenge of providing health care for California’s shifting demographics, has come up with 10 recommendations that they say could eliminate the shortage of primary care physicians and nearly eliminate the shortage of psychiatrists by 2030.
The catch? The recommendations come with a price tag of $3 billion. Implementing an additional 17 important recommendations would require a combined cost of $6 billion.
The numbers sound enormous, but they’re drops in the bucket of California’s total health-care spending. That $3 billion is less than 1 percent of what Californians are expected to spend on health care in 2019 alone.
Plus, the state may have no choice but to change how it’s attracting and training health care workers.
Parts of the state, especially in the fast-growing inland regions, are already experiencing critical shortages of primary care, dental or mental health care providers. The looming retirements of the Baby Boomer generation are expected to create care shortages for millions more Californians.
The most important changes the commission recommends have to do with the structure of health care operations and training in California.
It recommends expanding the authority of nurse practitioners, for example, especially in rural and underserved communities. This would surely incur the wrath of physicians’ associations.
Another recommendation is to establish a family of jobs — with career ladders — for home health care workers. This is the kind of change that could enrage nurses’ groups.
Both ideas must be pursued anyway. California’s population is diverse, but its health care workforce is not. Filling the state’s workforce gaps will require increased investments in attracting, training and retaining people of color to be physicians and nurses, and many of the commission’s recommendations revolve around ways to do this.
It suggests expanding and scaling pipeline programs for lower-income and underrepresented students — starting as early as high school. There’s a particular need for students to pursue the professions facing critical shortages in rural and underserved areas, and the commission recommends offering them scholarships as a form of encouragement. Considering the weight of student debt, the commission’s idea may be a wise one.
As for the all-important question of who will pay for these investments, the answer may be a mix of partnerships, instead of a simple line item from the state. But when it comes the future of health in California, the money may count as a far smaller cost than continuing with the status quo.