'An unstable situation': The access crisis is already here

The access crisis is already here

When we asked Richard Anderson, M.D., FACP, chairman and CEO of The Doctors Company and TDC Group, how close the country is to an acute access crisis, his answer was blunt: we're already in one.

"In a sense, we are in the middle of a rolling access crisis," Anderson said. The uninsured rate, which had fallen to historic lows, is starting to climb again. For patients without coverage, the consequences are stark — either they go without care, or they get it and risk financial ruin. Medical bills remain the most common cause of personal bankruptcy across most of the United States, he noted.

Consolidation is making it worse. As large corporations acquire hospitals and health systems, Anderson said, the financial calculus often works against rural communities. Facilities that aren't profitable get closed or stripped down to only the services that turn a margin. The result shows up in stark numbers: about 60% of rural hospitals in the United States no longer provide obstetrical care. A similar share have eliminated at least one other form of specialized care.

"The safety net in rural areas is becoming dangerously frayed," Anderson said, "and it is part of a larger access-to-care issue we have not solved."

For physicians practicing in those communities, the pressure is compounding — fewer resources, more uninsured patients and a system increasingly organized around what's financially viable rather than what's needed.