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Editorial: ACA will force changes in health care delivery

New Mexico’s health care picture isn’t exactly rosy right now, and it’s likely to get worse.

As the Patient Protection and Affordable Care Act, or Obamacare, takes effect next year and 172,000 uninsured New Mexicans are eligible to receive medical care either though an expanded Medicaid program or state insurance exchanges, New Mexico’s already strapped system will become even more stressed.

Bottom line: You should expect a longer wait to see your doctor and a harder time getting to a specialist — and if you’re basically healthy expect to see a nurse practitioner or physician’s assistant instead of a doctor — if you can find one, according to a Legislative Finance Committee report.

The report points out that the state doesn’t have enough health care professionals to meet current demand, much less provide care for the influx of newly insured people next year. Doctors, nurses and other professionals already are in short supply in rural areas, where the population often is older and most in need of services.

And seeing a health care worker with less than a doctor’s education and training could still be problematic because the state currently graduates fewer nurse practitioners than it does doctors. The report also found that New Mexico colleges awarded fewer registered nurse degrees in 2011 than it did in 2007 even though the state has funded nursing programs to the tune of $28 million since 2004.


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The report’s recommendations include allowing physician assistants more latitude to practice outside of a doctor’s supervision, increasing coordinated care for people with chronic illnesses, providing more money to train physicians in family medicine, expanding student loan repayment programs for doctors and eliminating state licensing roadblocks that hamper efforts to recruit health care professionals.

Also among recommendations is changing how care is delivered and focusing on preventative practices that try to keep people healthy instead of waiting until they are sick to treat them. That’s good advice, but likely a long-term goal as far as access is concerned.

Public dollars cover a large portion of health care costs, so developing workable prescriptions for an overwhelmed system should be a matter of intense public interest and debate.

Time is short; the change is now just over seven months away. But the LFC focusing on this issue is a good thing if it can lead to an effective state policy to address the changing needs.

This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.