Earlier installments in this series (here and here) have been exploring the reasons for the historic shortage in nurses currently looming over America. As stated by Georgetown University Center on Education and the Workforce, there are
- Baby Boomers are retiring en masse.
- The aging American population needs more access to healthcare services.
- More Americans have gained access to healthcare services due to the Affordable Care Act.
- As a cost-saving innovation, nurse practitioners are needed in greater numbers to serve the greater need, and
- A large number of people with nursing licenses do not work as nurses.
The first two reasons we addressed in parts 1 and 2 of this series.
The third and fourth reasons for needing more nurses are both related to the Affordable Care Act.
Sizing up the problem
- Upon passage of the Affordable Care Act (“Obamacare”), an estimated 30 million more people became insured. This brought the uninsured rate to its lowest point in 50 years.
- Prior to ACA, 48.6 million people (almost 16 percent of the American population) were uninsured, according to Bradley University.
- Georgetown University’s Center on Education and the Workforce projects a nursing shortfall of 200,000 by 2020.
Sizing up the growth potential
Obviously, if American healthcare is to retain its reach and effectiveness, such a shortfall will not stand. The market is projected to respond with historic rates of growth. The Health Resources and Services Administration (HRSA) projects a 30 percent increase in the supply of primary-care nurse practitioners between 2010 and 2020.
As of 2016, there are 214 nursing programs available nationwide to transition RNs with diplomas and associate degrees to the master’s-degree level, about triple the number of programs that existed 20 years ago. That trend is likely to continue.
Awaiting the unknown
Of the two impending unknowns that could affect the nursing deficit — healthcare overhaul and tax reform — dismantling of the ACA could prove especially disruptive.
The 2017 report, “Nursing: Can It Remain a Source of Upward Mobility Amidst Healthcare Turmoil?” from the Center on Education and the Workforce estimates that 156,000 nursing jobs will be put at risk if the Affordable Care Act is repealed and replaced. […] These job losses would result from a lower demand for healthcare services due to a loss of health insurance coverage for millions of people” (p. 6).
Perhaps more imminent are possible effects of the GOP tax-reform bill expected to emerge from conference committee by the end of the year, particularly with regard to student loans. It’s too soon to tell how things will settle out, but if the student-loan interest deduction is discontinued, as proposed, that could have a disproportionately negative impact on the healthcare workforce. That’s because it could deter some would-be medical students, including nurses, as reported by the online medical-news site STAT. One might reasonably expect this to cause people considering healthcare to choose something else.
But in contrast, one survey found that among fourth-year osteopathic medical students, debt does not dictate their specialty choices. Until the House and Senate tax-reform bills are reconciled, we won’t know enough to predict the effects on the nursing deficit.
We at tekMountain, one of America’s leading entrepreneurial and innovation centers, believe that, in the long term, the implications will not be all negative. Labor-market projections for healthcare are bullish. Projections call for large increases in all frontline healthcare professions, including home healthcare aides, registered nurses and doctors. These increases will depend on a proliferation or enlarging of nursing programs. For tech entrepreneurs and investors, the ancillary need to track student progress and standardize student records presents an unprecedented opportunity that we will address in a forthcoming part in this series.