Undoubtedly as the population ages the need for oncology services will intensify. The only question to ask is will there be funds to pay for this bigger need and where will it come from in this economy? The former debate between the Republicans and Democrats over health care really centers on whether it should have happened at all, and if it does who will pay for the additional thirty million people to be insured. Concerns have been brought to light that the expenditure will be alleviated by cuts to Medicare and Social Security. Any cutbacks to these programs by representatives have long been considered political suicide. To deflect any attacks from opponents of their program the administration states: "The Act will protect and preserve Medicare as a commitment to America's seniors. ...The Act takes important steps to make sure that we can keep the commitment of Medicare for the next generation of seniors. Medicare is a sacred trust with America's seniors, and this Act preserves it." I can feel the affection. Another attack is that the program will intensify the fiscal obligation on state and the federal government but they counter that; "It will save thousands of dollars in drug costs for Medicare beneficiaries by closing the coverage gap called the 'donut hole'." Doctors, nurses and hospitals will be given incentives so they will increase care and lessen unnecessary accidents that cause harm to patients. They even propose that this plan will save the public money by "ending massive overpayments to insurance companies that cost American taxpayers billions of dollars per year." A good bet is that, it will cost more than they believe, and the savings will be less. However, it is abundantly clear that the intensification in health care costs is unsustainable and the current economic climate is exacerbating the problem. When millions lose their careers, they also lose their health insurance, a dire situation for many who are the most vulnerable, the young, old and those suffering from poverty. Growing Demand A recent study states the number of oncologists has more than doubled over the past two decades, supply is predicted to only rise 20% between now and 2020. Need for oncology services is predicted to grow by 48% during the same time period. Projections were based on current cancer rates and delivery patterns applied to the expected U.S. population in 2020. Without a dramatic change in cancer care treatment or delivery between now and 2020, the nation is will face an acute shortage of oncologists.* There are about thirteen thousand oncologists active in the United States. Over 50 percent of all oncologists are aged fifty or greater and will be sixty five or older by the year 2020. About five hundred fellows annually complete an oncology post-graduate education program, and oncology program directors report limited plans to increase the number of training slots between now and the 2010-11 academic year.* Oncology historically provides care to one sector of the population, the growing populace of people aged sixty five or older. In addition, as treatment has become more unbeaten there are more cancer survivors to care for for extended periods of time which contributes to an increase in need and demand for oncologists. In fact, Cancer survivors make up a substantial proportion of overall oncologist visits. * As a result, the distribution of and want for oncologists is projected to move from a virtual state of balance in 2005 to a state of acute shortage in 2020, with visit demand growing at a much quicker pace than the available visit supply.* Healthcare Reform Even with the health bill finally signed into law its effect on our health care is not identified. By 2014 there will be an escalation in the enrollment into insurance programs. This increase when, pooled with the long term aging of the populace, should push want for services and therefore prices higher. However, no one yet knows what will happen to recompense rates from Medicare and this new program. The question is will there be a cut of reimbursement amounts for different specialties by Medicaid and this new program that may contrarily become a decreasing factor of the income of all specialties including Oncologists and related specialties/subspecialties. *American Society of Clinical Oncology commissioned the Center for Workforce Studies at the Association of American Medical Colleges
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Obviously as the populace ages the need for oncology services will increase.
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