Impact Of Increasing Physician Supply: A Scenario for the Future

Prologue: The ratio of physicians to population has increased sharply over the last two decades as a consequence of federal and state policies that have encouraged the education of more medical doctors. But controversy stalks the question over what this increasing supply means to the future configuration of American medical care. In this article, economists Harold Luft and Peter Arno take a different perspective than most of their professional colleagues who have addressed the issue of physician supply. They argue that in today's rapidly changing health care environment it is not useful to take econometrically based models of physician supply that are based on past experience and project them into the future to determine implications for cost, access, quality, and other health policy issues. While projections of the impact of growing numbers of physicians on the U.S. health care system are needed, Luft and Arno offer some alternative models and scenarios for making these predictions. They argue that a combination of models provides a better starting point for discussions of future implications. Luft, who is professor of health economics at the Institute for Health Policy Studies in the University of California, San Francisco (UCSF) School of Medicine, received his doctorate in economics from Harvard University. He worked at the postdoctoral level at the Harvard Center for Community Health and Medical Care and spent five years as an assistant professor at Stanford before joining UCSF. Arno is assistant professor of health care administration at Baruch College/Mt. Sinai Medical School at City University of New York. He received his doctorate in economics from the New School for Social Research and worked as a Pew Postdoctoral Fellow at the UCSF Institute for Health Policy Studies.