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Health Care Issues: Shortage of Doctors

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By The Associated Press
A look at key issues in the health care debate:

THE ISSUE: Will there be enough doctors to provide care to millions of previously uninsured patients if health reform is passed?

THE POLITICS: With primary-care doctors in limited supply, Republicans opposed to sweeping reform say the health care system would be overwhelmed if nearly 50 million uninsured Americans are given coverage. As is, the American Academy of Family Physicians is predicting a shortage of 40,000 primary-care doctors by 2020, with medical schools graduating only half the number needed to meet demand. Democrats and the Obama administration do not dispute looming shortages, now seen in many poor and rural areas, that could lead to longer waits and more emergency-room visits. But they argue that health care legislation would address those problems.

WHAT IT MEANS: Due to increasing medical demands from aging baby boomers, the U.S. faces a dangerous shortage of primary-care doctors whether sweeping overhaul is passed or not. Several doctors’ groups are backing the legislation, citing in part provisions to expand the work force. For example, the proposed House legislation would add funds, loan repayment and training grant programs designed to promote use of specialized nurses, encourage doctors to work in underserved areas and entice new students into primary care. Existing medical schools also have begun to increase enrollment, while new schools are under development from El Paso in West Texas to Kalamazoo in western Michigan. Still, it remains to be seen whether the efforts will be far and fast enough, given the long-standing attraction of medical specialties which offer students higher salaries and more prestige.

Doctors Call for Patient-Centered Health Reform

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RALEIGH, N.C. – The Coalition to Protect Patients’ Rights will host a press conference Thursday at the Raleigh Convention Center with local Coalition members, local doctors, and medical professionals to discuss the need for patient-centered healthcare reform.

The Coalition is urging Members of Congress to slow down any health system overhaul and take the necessary time to develop policies that will keep strengthen our health care system and keep patients first.

Date/Time:     Thursday, August 27, 2009, 11:30 a.m.
Location:       Raleigh Convention Center, Room 201
500 South Salisbury Street
Raleigh, NC 27601

Participants:  Dr. Donald Palmisano, spokesman for the Coalition to Protect Patients’ Rights and former president of the American Medical Association

About the Coalition to Protect Patients’ Rights

The Coalition to Protect Patients Rights is a non-partisan, grassroots coalition made up of patients, healthcare providers, advocacy groups, and concerned citizens who are dedicated to the implementation of patient-centered healthcare reform that will improve patient care by strengthening health IT, supporting comparative effectiveness research (CER), encouraging continued medical innovation, and protecting the sanctity of the doctor-patient relationship.

Doctors and Executions

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Editorial from the Winston-Salem Journal

A ruling from the N.C. Supreme Court brings the state a step closer to resuming executions. Other cases are still pending. Questions from legislators should be pending as well. The General Assembly needs to tackle the issue raised in the case: Should doctors participate in executions? And before it takes up that and other questions, it should impose an official moratorium on the death penalty.

There’s been an unofficial moratorium as the courts wrestle with the doctor question. The last inmate executed was Samuel Flippen of Forsyth County, who was convicted of killing his two-year-old stepdaughter. He was put to death in August 2006. Since then, 163 people have sat in limbo on death row as the courts responded to the question of whether doctors should participate in executions. Doctors had been assuring the proper doses of lethal drugs at executions and certifying death.

The state Supreme Court ruled 4-3 in favor of the N.C. Department of Correction earlier this month, saying that the N.C. Medical Board overstepped its authority when it issued a position statement saying it could punish doctors for participating in an execution.

As we said on this page in December, this is a matter of public policy. Associate Justice Patricia Timmons-Goodson reiterated in her dissent that the N.C. General Assembly should decide. The failure of the legislature to address the question has meant that it has inappropriately landed in court.

Gov. Bev. Perdue should encourage legislators to take up this issue. And despite pleas from Republican leaders that executions resume, she should ask the legislature to declare a moratorium until all outstanding issues are resolved.

Other lawsuits over the state’s execution procedures are pending, the Journal’s Dan Galindo and Paul Garber reported. Those suits include one in Wake Superior Court challenging how the N.C. Council of State changed execution procedures in 2007 to require someone with medical training to play a role in the execution.
Although a few legislators have continued to keep the death penalty issue in the forefront during the unofficial moratorium, it has given many others a break from the controversial topic.

A House select committee’s study of capital punishment underscored that the big questions have not gone away. Reforms in the legal discovery process, recording of interrogations and police lineup procedures have been implemented and are welcome, but much more is needed. High-profile cases have continued to expose the flaws in the system, including mistakes made by police, prosecutors and defense attorneys.

From December 2007 through the spring of last year, three men who had been on death row – Glen Edward Chapman, Jonathan Hoffman and Levon “Bo” Jones – were freed from prison after serious flaws in their cases were finally exposed. It’s sobering to consider that they could have been executed before the truth was discovered. “You can overturn a wrongful conviction, but you can’t unpack a wrong grave,” the Rev. William Barber of the NAACP said at a press conference with the three men last year, according to the Raleigh News & Observer.

In several other states, DNA testing has either freed or helped free prisoners from death row.
Most death penalty cases aren’t as dramatic. In most cases, there’s little question that the prisoners are guilty of the crimes for which they’ve been convicted. But there are serious questions about the application of the death penalty in some cases when defendants in equally brutal crimes drew life in prison.

The death sentence is often imposed arbitrarily. Sometimes, it seems it’s just a matter of geography. Flippen was convicted of hitting Britnie Nichol Hutton so hard that her liver and pancreas were torn, but people who have committed even worse crimes in this state have not been subjected to the ultimate punishment. For example, in liberal Orange County, a woman charged in 2005 with killing her best friend’s daughter by placing her in scalding water did not face the death penalty.

Gender plays a big role as well, with women rarely facing the death penalty in this state. As does race, class and money.

These issues must be dealt with. Whether or not the courts clear the way for executions to resume, citizens should insist that the legislature declare a moratorium on the death penalty as it seeks to resolve these issues. The condemned, after all, are killed in the name of each and every one of us.

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