The Senate Committee on Health, Education, Labor, and Pensions will come to order.
Today we are holding a hearing to examine the healthcare workforce challenges that our country faces. I will give an opening statement, followed by Ranking Member Cassidy, and then we will introduce the witnesses.
After the witnesses give their testimony, Senators will each have five minutes to question the witnesses.
Let me begin by thanking Ranking Member Cassidy, all Senators and the panelists for being with us today to discuss this enormously important issue.
It's no secret that our country faces many health care crises. Despite spending almost twice as much per capita as almost any other major country on healthcare -- nearly $13,000 for every man, woman and child -- 85 million Americans are uninsured or under-insured, over 500,000 Americans go bankrupt each year because of medically related debt, and we pay by far the highest prices in the world for prescription drugs.
It is my expectation that over the next many months our committee will address all of these healthcare issues and more.
But today, we're going to focus on another major healthcare crisis and that is, despite all of our healthcare spending, we don't have enough doctors, nurses, nurse practitioners, dentists, dental hygienists, pharmacists, mental health providers, and other medical professionals.
And what is the impact of those health provider shortages? It means that nearly 100 million of our people live in a primary care desert where they are unable to gain timely access to a doctor when they need it. It means that nearly 70 million live in a dental care desert, unable to get dental care while teeth are rotting in their mouths. And it means that some 158 million Americans -- nearly half the population -- live in a mental health care desert at a time when this country is facing a major crisis in mental health.
Simply put, it means that a significant percentage of our population live in places where they cannot access the healthcare they desperately need.
In my view, this reality is a contributing factor to the declining life expectancy we are seeing in many parts of our country, and the fact that our overall life expectancy is significantly lower than many other industrialized countries. Life expectancy is not simply a factor of healthcare access, but it is an important factor. If people do not get to a doctor when they should, if they cannot afford the prescription drugs their doctors prescribe they will die earlier than they should and suffer unnecessary, debilitating pain.
And here is a point that you are going to hear me make very often. And that is not only does the lack of medical professionals in many parts of the country lead to increased human suffering and unnecessary death, it is incredibly wasteful from a financial perspective. If people cannot access a primary care doctor, they may end up in an emergency room which is the most expensive form of primary healthcare. And if their illnesses continue to go untreated, they may end up in a hospital and could run up bills of tens or hundreds of thousands of dollars. Study after study shows that disease prevention saves money. If people are able to access care when they need it; if there are enough medical professionals to provide that care in every part of this country, our healthcare costs will go down.
A shortage of healthcare personnel was a problem before the pandemic and now it has gotten worse. Health care jobs have gotten more challenging and, in some cases, more dangerous. Many thousands of health care workers have died from COVID taking care of the American people, and many more have become sick.
According to the best estimates, over the next decade, our country faces a shortage of over 120,000 doctors -- including a huge shortage of primary care doctors.
Over the next two years, it is estimated that we will need up to 450,000 more nurses.
Today, it is estimated that we need about 100,000 more dentists -- right now.
And in America today, there is a massive shortage -- many, many hundreds of thousands -- of mental health service providers -- psychiatrists, psychologists, social workers, counselors, addiction specialists and many more.
In addition to our overall crisis in healthcare providers that problem is especially acute in minority communities. We desperately need more African American, Latino, and Native American healthcare personnel who are way under-represented in the healthcare profession.
How we address these crises is the subject of today's hearing and of a lot more future discussions. But talk and hearings are not good enough. The American people want this committee to produce some serious legislation that address these crises, and that is exactly what we must do. Let me say a few words on what I believe to be some of the obvious steps forwards as we grapple with this issue.
First, it is a no brainer to understand that, when over 10,000 medical school graduates are unable to find residency slots every year, we must significantly expand and improve the Graduate Medical Education program. Further, and in the jurisdiction of this committee, we must also greatly expand the Teaching Health Center program which will allow us to grow significantly the number of primary care physicians and nurses we desperately need.
At a time when young people are graduating from medical school, dental school, and nursing school, deeply in debt -- sometimes to the tune of $400,000 or $500,000 -- it is pretty obvious that those graduates are not going to practice in under-served areas where they will earn less money than those who practice in more affluent communities. That is why we must substantially increase student loan debt forgiveness and scholarships that the National Health Service Corps program provides. We have expanded that program in recent years, for doctors, nurses, dentists and mental health providers, but much more needs to be done.
Further, in terms of nursing, despite a major nursing shortage, we have the absurd situation that in many parts of this country, including Vermont, nursing schools are rejecting applicants because they don't have the nurse educators and facilities they need.
In Vermont, as an example, nurse educators earn about $65,000 a year -- nearly half of what nurses with similar degrees earn working in a hospital. We need to make sure that nursing schools throughout the country have the staffing and facilities to educate the number of new nurses that we will need. In my view, that means we also need to substantially expand and reform, the Nurse Corps and the Nurse Faculty Loan Program, among many other programs.
And let's be clear -- the issues we are talking about today are just part of the problem. Our committee must also grapple with broader health care workforce challenges. Pharmacies across the country are having trouble hiring pharmacists. We don't have enough home healthcare workers. We don't have enough nursing home staff, etc., etc.
Further, this crisis also extends to emergency medical services (EMS) and our first responders. These heroic workers are often the first people there during someone's most difficult moments, and often are the difference between life and death. And yet, in rural parts of Vermont and throughout this country, EMS workers are often volunteers or underpaid professionals.
I now recognize Ranking Member Cassidy for his opening remarks.