State should invest in Florida’s healthcare future

Sometime in 2014, Florida will pass New York to become the third-most-populous state in the United States. Approximately 70 percent of new Floridians come from other states or other countries. They are drawn here by our wonderful weather, beautiful environment, unmatched recreation, low taxes, job opportunities and cultural diversity and acceptance.

They also find world-class healthcare. Our 300 hospitals and dozens of specialized medical centers offer state-of-the-art care to Florida residents, and scores of additional patients come from outside Florida each year to take advantage of procedures that are unavailable or not as advanced where they live.

The state’s nine medical schools play a critical role in providing top-notch clinical care, cutting-edge biomedical research and outstanding education for the next generation of Florida physicians. Two of these research medical schools, the University of Miami Miller School of Medicine and the University of Florida College of Medicine, are ranked in the top 50 nationally based on the overall size of the research grants received from the National Institutes of Health.

But growth is always accompanied by challenges. Our population will continue to grow, and the projections are that it will increase by another 10 percent, reaching more than 21 million, by 2020. Florida already has a shortage of physicians, and more than 35 percent currently practicing in the state are over the age of 56. A growing patient population, including new patients brought into the market by the Affordable Care Act, threatens to overload our resources and lower our quality of care.

Florida is far from alone in this concern. The Department of Health and Human Services projects that the nation as a whole will face a shortage of 90,000 physicians in the next 10 years. The biggest reason is the lack of residency slots to train new medical school graduates. The result is that many of our graduates move to other states to train, and they don’t come back.

By 2020, Florida’s medical schools are projected to graduate 1,350 new M.D.s annually, but only 820 residency slots are expected to be available.

Historically, residencies have been funded by the federal government, but the Balanced Budget Act of 1997 placed a cap on Medicare funding for advanced medical training. Our shortage of residency openings today will require new and creative solutions that likely will involve the Centers for Medicare & Medicaid Services, the state and Florida hospitals.

Academic medical centers also face sequester-mandated budget cuts at the National Institutes of Health that have significantly reduced federal grants for biomedical research across the country — research that is critical for developing the novel drugs and therapies needed to defeat the diseases that afflict mankind.

Slowing the pace and quality of biomedical research will trigger a huge potential loss for all of us. An entire generation of new scientists is at risk, together with their new ideas and discoveries for science and novel therapeutic strategies.

Florida Gov. Rick Scott entered politics following extensive experience in the hospital industry. He understands the math of healthcare and recognizes that funding shortages represent a risk to the health of the state, as well as its people.

As a result, he and the Legislature have begun taking action to fill some of the federal funding gaps. In 2013, the state provided $80 million to fund 700 residency slots and $50 million for cancer research. Now Gov. Scott is proposing an additional $80 million for cancer research in the state’s next fiscal year, which begins on July 1.

These are admirable initiatives. Gov. Scott should be commended for such bold and important projects. However, they will not cover all that Florida’s healthcare system ultimately will require. Until Washington can find a way to relax the constraints on federal funding, the state should continue — and strengthen — its support for our healthcare needs. Not only will it improve the health of Floridians, it’s also a smart investment: Growth in healthcare brings more companies, more jobs and greater revenues, and a healthy workforce is a more-productive workforce.

No matter where Florida ranks by other measurements, in quality of healthcare we want to be No. 1.

Pascal J. Goldschmidt, M.D., is senior vice president for medical affairs and dean of the University of Miami Miller School of Medicine and CEO of UHealth .

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