The Health Care Workforce Reform

By Lamm, Richard D. | State Legislatures, August 1994 | Go to article overview

The Health Care Workforce Reform


Lamm, Richard D., State Legislatures


Public policy, like von Clausewitz's generals, tends to fight the last war. Too often we legislate for the world that was--not is. "Policy is formed by preconceptions and by long implanted biases," Barbara Tuchman says. "When information is relayed to policymakers, they respond in terms of what is already inside their heads and consequently make policy less to fit the facts than to fit the baggage that has accumulated since childhood."

Public policy is obliged to recognize and adapt to new realities. The old world of public policy is always in tension with the new, and change does not come easily. Let me use the example of reforming our health care system. As we struggle to rationalize the financing and delivery of health care, we too often neglect a critical component--the health care workforce. America's 10.5 million health care workers have a tremendous impact on the cost, quality and accessibility of our system. America trains the wrong numbers and types of providers and does not use them effectively. The old world of care delivery is changing dramatically, and without a similarly dramatic change in the health care workforce, we will create irreparable tensions. A new reality is upon us.

States, which control the education and regulation of health care providers, must craft new and assertive public policy to produce a health workforce that can deliver the promises of a reformed system. Some states are responding, and many have realized that by changing education and training, regulation and utilization, the health care workforce can become the foundation of an efficient, high quality and equitable new system.

As a general rule, state planning has seldom been comprehensive. It usually targets specific provider shortages and avoids the heavy lifting necessary for more comprehensive solutions. Work-force reform requires data collection, analysis and action. Statewide, or even regional, public-private consortia should be formed to ensure that schools train the right types and mix of providers and that the states regulate them efficiently. Washington, Missouri, Colorado, New York and a number of other states have begun to address workforce planning comprehensively.

The shortage of primary care physicians and the expansion of managed care should drive states to scrutinize their $3 billion investment in health professions education. Public money should fund public needs. State medical schools should reduce the number of specialists and increase the number of general physicians in training. Thirty-two states have passed bills creating incentives for primary care education and training. Washington, Minnesota and Tennessee require their state-supported medical schools to meet targets for graduating primary care physicians. Medical schools seldom change on their own--we must respectfully push them. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

The Health Care Workforce Reform
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.