https://washingtonian.com/2020/04/13/were-short-on-healthcare-workers-why-doesnt-the-u-s-just-make-more-doctors/

Many Americans may not know that the number of doctors is essentially set by Congress. Each year, the Centers for Medicare & Medicaid Services, or CMS, provides payments to hospitals to hire their residents—the crucial bridge that medical school students must take to becoming licensed physicians. Because the number of residencies is tantamount to the final number of doctors, the federal government has enormous leverage over the number of new physicians that enter medicine each year.

But the number of new residencies for which the federal government pays has not budged in twenty years. In 1997, Congress passed the Balanced Budget Act, a bipartisan effort to cut back on spending. The act put a cap on the number of annual residencies CMS would support, and froze the funding at 1996 levels.

Within years, medical experts began warning that a doctor shortage was in the offing. Since 2007, a bill to increase the number of residencies has been introduced in every Congress—including five times by Joe Crowley of New York, who was later defeated by Alexandria Ocasio-Cortez—but never passed. Last year, the Resident Physician Shortage Reduction Act of 2019 was proposed by Terri Sewell, a Democrat from Alabama, which would increase the number of residencies by about 3,000 for five years. It also grants the Secretary of Health and Human Services flexibility to determine to which regions those residents will go, since geography is a key aspect of the country’s shortage.

Sewell’s measure would make a big dent. But the aggregate increase in doctors would only amount to about 15,000. According to the Association of American Medical Colleges—the country’s leading advocates for lifting the residency cap—the shortage of total physicians by 2032 is projected to be between 46,900 and 121,900. At least half of that shortage is expected to be among primary care physicians alone.