“A Rhode Island doctor who is an assistant professor at Brown University’s medical school has been deported to Lebanon even though a judge had issued an order blocking the U.S. visa holder’s immediate removal from the country, according to court papers.
The expulsion of Dr. Rasha Alawieh, 34, is set to be the focus of a hearing on Monday before a federal judge in Boston, who on Sunday demanded information on whether U.S. Customs and Border Protection had “willfully” disobeyed his order.”
https://www.yahoo.com/news/doctor-brown-university-deported-lebanon-221023691.html
“Certificate of need (CON) laws exist in various forms in 38 states and Washington, D.C. The stated goal of such laws is to keep costs down by preventing overinvestment in any single market. If regulators decide an area already has enough of any type of service, they can block new construction.
As a result, nobody in North Carolina can open or expand certain medical facilities without these regulators’ permission. Even purchasing an MRI scanner without their approval can be illegal. These restrictions prohibit Singleton from using his own clinic in New Bern for most of the surgeries he performs. He must drive two miles up the road to a competitor’s office, as it is owned by a major health care player. This unnecessary red tape increases costs and decreases scheduling options, and patients suffer.
Singleton has battled this scheme since he set up his clinic in 2024. Frustrated by a wall of bureaucracy and lack of progress, he sued in 2020 with representation from our public interest law firm, the Institute for Justice.
Getting to trial has not been easy. Wake County Superior Court tossed out his case in 2021 without discovery or witness testimony, and the North Carolina Court of Appeals upheld that decision in 2022. The state Supreme Court ruling simply allows Singleton to go back and try again.
Singleton is not alone in this struggle. The Iowa ophthalmologist Lee Birchansky fought for more than 20 years before state regulators relented and gave him permission to perform surgeries at his own clinic. In 2016, Virginia fended off a CON lawsuit from pulmonologist Mark Baumel and radiologist Mark Monteferrante. Kentucky spiked a home health care service that entrepreneur Dipendra Tiwari tried to launch in 2019. Connecticut blocked a cancer treatment center in 2022, clearing the way for political insiders to proceed unimpeded with their own cancer treatment center 45 miles east. None of these cases involved health or safety concerns.
CON laws work great for existing providers, who do not have to worry about rivals setting up shop and attracting patients with superior service. This also means existing providers can also take their doctors and nurses for granted, as CON laws keep rivals far away, limiting their ability to poach talent.
California, Texas, and 10 other states operate without CON laws. None of these states has experienced any measurable harm. In fact, multiple studies show benefits. For example, Matthew Mitchell, a researcher at George Mason University’s Mercatus Center, says states that got rid of their CON laws have more hospitals and surgery centers per capita, along with more hospital beds, dialysis clinics, and hospice care facilities.”
https://reason.com/2024/10/29/doctor-fighting-to-break-certificate-of-need-barrier-in-north-carolina/
“The US does have significantly fewer doctors per capita than some other wealthy nations, such as Germany and Sweden. But America’s physician-to-patient ratio is actually about the same as other developed countries — Canada, the United Kingdom, Japan, France — that still generally rank better on measures of health care quality than the US does. So aggregate numbers alone are not enough to explain the access problems that patients face, and experts disagree over whether we need to boost the overall supply of providers in the short term.
The bigger problem is misallocation in the US physician workforce, Coffman told me last year. We know that we don’t have enough doctors in certain important specialties: primary care, obstetrics, and psychiatry, for example. We also don’t have nearly enough providers in a broad swath of specialties practicing in rural and other low-income communities. Between 2010 and 2017, while large urban counties added 10 doctors per 100,000 people on average, rural counties lost three. As a result, metro regions had 125 doctors per 100,00 patients, while rural areas had 60.
America is littered with doctor deserts, areas where there are not enough primary care providers, much less specialists or hospital-level services. The federal government estimates that 80 percent of rural Americans live in medically underserved communities.
In the long term, the US will undoubtedly need more doctors in rural and urban areas alike. Groups like the Association of American Medical Colleges continue to project long-term workforce shortages, as boomer-generation doctors reach retirement age and the population of seniors requiring medical care swells.”
https://www.vox.com/future-perfect/361620/bloomberg-johns-hopkins-free-medical-school-doctor-shortage
“in hundreds of communities, the doctor shortage isn’t a distant concern; it’s happening. America doesn’t have enough physicians practicing in certain parts of the country and in critical specialties. There are not enough primary care doctors in small towns and poor city neighborhoods alike. There are not enough obstetricians in rural practices. There are not enough psychiatrists almost anywhere.
The vast majority of rural America, 80 percent, is considered by the federal government to be medically underserved. About 20 percent of the US population lives in rural communities, but only 10 percent of doctors practice there.
These localized shortages — call them doctor deserts — are not inevitable. They are, in part, the result of policy choices. Doctors tend to spend their careers near the place they spent their residencies, several additional years of training they undergo after medical school. These residencies are paid for by the federal government, through Medicare, and virtually all are at big, academic medical centers, rather than in the places where people most need care right now.
If the US wants more doctors practicing in small towns, then it needs to put residencies there.”
…
“The answer to “does America have enough doctors overall” is complicated and arguably somewhat unclear. The US has significantly fewer doctors per capita than some other wealthy nations, such as Germany and Sweden. But US numbers are actually about the same as a number of other developed countries — Canada, the United Kingdom, Japan, France — that still generally rank better on measures of health care quality than the US does.
Groups like the Association of American Medical Colleges continue to project long-term workforce shortages. Demographic trends, including an aging patient population and boomer-generation doctors reaching retirement age, may lead to more overall pressure on the US health system’s capacity.
But the more acute shortages are already happening in individual communities and specialties.”
“Starting your own medical practice is hard. In some states, it’s almost impossible due to the monopoly power of politically connected hospital associations. Independent doctors and patients tried for 10 years in South Carolina before finally scoring a victory last month.
On May 16, South Carolina Gov. Henry McMaster signed legislation to repeal most of the state’s medical certificate of need (CON) laws. A CON is a government permission slip that health care providers must obtain before they can launch or expand services. Spending money to provide safe, affordable care is illegal without this piece of paper.
Big hospitals love the red tape. Instead of competing with would-be rivals on a level playing field, they can claim their turf and defend it using government interference on their behalf. Many states even allow established providers to object to rival CON applications, giving them something like veto power.
If McDonald’s had the same authority, local franchisees could block mom-and-pop burger joints from opening nearby. The Home Depot could block family hardware stores. And LA Fitness could block independent gyms.”
““Cutting Medicaid — yeah,” Davidson said. “The head of CMS [the Centers for Medicare and Medicaid Services] announced the plan to let states file for waivers so they could get block grants, so that would essentially cut the amount of money going to states. So that would cut federal Medicaid funding.””
…
“”I think it comes down to that for the people I take care of all the time,” responded Davidson. “People I see in the emergency department that can’t get primary care doctors, [but] once they got Medicaid they could get primary care doctors. They stay out of the ER, they actually work more, they actually contributed to our community more.”
“Now, if you tell those people, ‘Sorry, you don’t get your health care’ — that’s going to be a real negative in their lives,” Davidson continued.”