MENLO PARK, CA (Managed Care Wire): Americans rank the cost of healthcare as their third biggest economic problem, following the price of gas and concerns about jobs, according to a Kaiser Family Foundation poll.

The poll, which had a margin of sampling error of plus or minus 3 percentage points, studied a nationally representative random sample of 2,003 adults who were interviewed by telephone between April 3 and 13.

“Problems paying for healthcare and health insurance” as a result of recent economic changes was cited by 28 percent, the Kaiser poll found. Forty-four percent of those surveyed said that paying for gas was their top economic problem, and 29 percent cited getting a good-paying job or a raise in pay.

Respondents said they had less concern with paying their rent or mortgage (19 percent), dealing with credit-card or other personal debt (18 percent), paying for food (18 percent), or losing money in the stock market (16 percent).

“Many people view health and the economy as separate issues, but the cost of healthcare is a significant pocketbook issue for many families, and paying for healthcare has become a key dimension of the public’s economic concerns,” Kaiser President and CEO Drew E. Altman said.

WASHINGTON, DC (Managed Care Wire): The most recent Medicare trustees’ report calls for comprehensive reform to address the program’s long-term financing issues, according to the American Academy of Actuaries. Medicare’s hospital insurance expenditures exceed income from payroll taxes, and Medicare must also rely on interest accrued on trust-fund assets, the program’s trustees say.

Beginning in 2010, these expenditures will exceed income including interest, and Medicare will draw on its hospital insurance trust-fund assets. The trust fund is projected to be depleted by 2019, when tax revenues would cover only 78 percent of program costs.

“The sooner these long-term financing problems are addressed, the more flexible and gradual the solutions can be,” the Academy’s Senior Health Fellow Cori Uccello said. “All of the presidential and congressional candidates must not only acknowledge these problems but also offer insights as to how they would address them.”

BETHESDA, MD (Managed Care Wire): As the population of the United States increases and ages, the country faces a physician shortage that will affect adults’ primary care, says a study published in Health Affairs.

Family physicians and general internists will see their workloads increase by 29 percent between 2005 and 2025, and pediatricians and family physicians who care for children will see their workload increase by 13 percent. For the care of children, the physician supply should be adequate, but the study predicts a shortfall of 35,000-44,000 adult-care physicians.

The population of the United States will increase 18 percent between 2005 and 2025, to 349 million, and the population above age 65 will increase 73 percent.

Generalist physicians -- physicians in family medicine, general internal medicine and general pediatrics -- provide 52 percent of all ambulatory care visits, much inpatient care, 80 percent of patient visits for hypertension, and 69 percent of visits for both chronic obstructive pulmonary disease and diabetes, the study says.

The supply of physicians must increase to meet the higher demand for healthcare, but the number of generalist residency graduates has declined each year since 1998, and the supply of generalist physicians will increase by only 13 percent by 2025, the study says.

The study recommends several methods to increase the number of generalist physicians, especially the use of “medical homes,” which provide rapid access for acute problems and care management for chronic illnesses. Medical homes can improve access, improve care of chronic illness, and reduce emergency department visits and hospitalizations. The study also recommends stronger efforts to increase the number of medical graduates, more money for residency positions, and loan forgiveness for primary-care education.

For more information on the study, visit http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.3.w232.