The ineptness of government programs and employees is truly astounding, justifiably ridiculed, and a source of the enormous waste of tax dollars. Health care accounts for a lot of government spending and thus we have endless initiatives by governments to solve supposed problems in health status, provider access, quality of care, cost of care, and on and on and on. Billions of dollars on initiatives which if they were effective, would have solved all our health care problems by now. One long-standing concern has been a shortage of physicians and other providers in rural areas and in certain poorer urban areas. Since it is a “problem”, government must have a solution, or at least a program that can hire lots of people at inflated salaries who will contribute to Democrats.
In 1965 the federal government started to incentivize physicians to practice in designated provider-shortage areas. More than a billion dollars annually is spent on this program, so you add it up, but by reckoning that is well over $50 billion. And for that much money we get great results, right? No. During a study period from 1970 to 2018, 73% of counties which had shortages still had them at least ten years after they were designated, and there was no overall change in physician density. There also was no change in the difference in mortality rates in these areas, which continued to be higher than in non-shortage areas. The mortality finding could be confounded by the fact that physicians tend to gravitate to higher-income areas and persons living in those areas tend to be healthier.
Some have suggested that even bigger incentives be paid, in other words, let’s dump even more taxpayer money down the sewer. Paying physicians more to work where they don’t really want to doesn’t seem like a great solution in any event. Job satisfaction tends to spill over to the quality of patient care. But the most important lesson once again is that government programs, in health care or anywhere else, seldom do what they are supposed to. (HA Article)
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at 
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I think a large part of the problem is the cost of getting an MD. If new MDs were not burdened by debt more might choose to go into primary care. Primary care doesn’t pay well, the hours are inhumane, with a great deal of responsibility. A new MD in primary care, especially in rural areas, hardly makes enough to pay their student loans and have a middle class life. If medical school was free there might be more doctors willing to go into general practice primary care because their financial burden would be reduced. The job would be more attractive without the debt burden. Don’t know if this would work out, maybe it would just create more rich doctors, but I think it would help. Recently, Ruth Gottesman gave her fortune to Einstein to fund free education for every student, and into the future. Can you imagine the changes in everyday healthcare if the force of evil known as Soros (and others) did the same?
I’ve got a physician friend who works at a teaching hospital, he’s near retirement He said over the last twenty years the students in MD programs have completely changed. It used to be fairly smart people who knew they could cover the loan cost with the expected pay. Now the cost is so high the students are mostly women with sugar daddies paying the tuition and the school takes them despite their mediocre academic abilities because the sugar daddies can be counted on for donations.