Reduced costs for medical education would be the second to last alternative that would be likely to be effective. First, reducing the costs of medical eduction, through tax incentives and tuition caps, may make the medical field more attractive to some students; however, even with these in place, the costs would still be so significant that many potential future doctors would be still turned off from the profession. In contrast, free medical education would likely be very effective in recruiting students to pursue the medical profession. This would likely be especially attractive to good students who weren't good enough to receive significant scholarship money to help offset their education. However, this would be the most expensive alternative to implement for the United States. This cost could be offset by the service these doctors give, in exchange, for government-run medical facilities, but the infrastructure alone to this type of innovative plan would be astronomical.
Loosening restrictions for foreign doctors would be the next best alternative in the implementation of the PPACA and the increased need for healthcare professionals. There are a variety of countries that are providing world-class medical education to their students. The allure of coming to America would also likely be attractive to a wide variety of foreign doctors. However, there is a concern, as with reducing the educational requirements, that these doctors may not be up to the standards of American doctors. In addition, this is the only alternative that has national security concerns attached to it. Recruiting foreign doctors could be an avenue for terrorists, for this reason strict background checks and other national security procedures would have to be put into place. Logistically, ensuring the foreign education is fairly comparable, it would be difficult, but not impossible, and would meet the growing patient demand.
The most efficient alternative to meet this demand increase is the increased usage of nurses and nurse practitioners in the medical industry. These medical professionals are well-suited to take on an increasing number of tasks, to help fill the demand gap. In addition, the costs associated with nurse practitioner-provided services are significantly less than physican-provided services. However, the primary challenge with this alternative is the current shortage of nurses that already exists in the United States (Ganley & Sheets, 2009; Fox & Abrahamson, 2009). This will place an even greater strain on this profession and will need to be addressed by the healthcare industry, if they hope to have nursing professionals step up and meet much of this new demand.
Monitoring the Use of Nursing Professionals:
Much of monitoring the implementation of nursing professionals as the gap filler for the increased demand caused by the tens of millions of new patients entering the healthcare system, with the advent of PPACA, will be the same as monitoring the effectiveness of the PPACA itself. The Act cannot be successful without effectively and efficiently meeting this new demand. If it is successful, if almost all Americans are receiving high quality and low cost healthcare, in a timely manner, then this will mean that the nursing professionals used to fulfill increased responsibilities will have been a success as well. If healthcare is less than acceptable quality or if there are unacceptable waits for care for patients, then clearly the nursing professionals were not able to meet these new demands. This may not be the fault of the nurses, but rather would more likely be due to a lack of nurses, which is already a concern, or a deficit in the education needed to perform their new duties, or a variety of other facets that must be in place to support nurses as they take on increased responsibilities.
Fox, R. & Abrahamson, K. (Oct-Dec 2009). "A critical examination of the U.S. nursing shortage: Contributing factors, public policy implications." Nursing Forum, 44(4). p. 235-244.
Ganley, B. & Sheets, I. (Jul 2009). "Educational innovations: A strategy to address the nursing faculty shortage." Journal of Nursing Education, 48(7). p. 401-405.
Medical student debt. (2011). Retrieved January 9, 2011, from http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/medical-student-debt.shtml.
The Patient Protection and Affordable Care Act. (No date). Retrieved January 9, 2011, from http://dpc.senate.gov/healthreformbill/healthbill04.pdf.
Public Law No: 111-148: Patient Protection and Affordable Care Act. (13 Apr 2010), Retrieved January 9, 2011, from http://www.aacn.nche.edu/government/pdf/HCRreview.pdf.
The United States National Health Care Act, H.R. 676. (5 Feb 2010). Retrieved January 9, 2011, from http://www.healthcare-now.org/hr-676/.