Millions of Americans, including those who believe health care is a “right,” are in for a rude awakening: According to a 2018 report from the Association of American Medical Colleges, America faces a projected shortage of 42,600 to 121,300 physicians by 2030. Both ends of the span represent an increase from the 40,800 to 104,900 doctor shortage the AAMC projected in 2017.

“This year’s analysis reinforces the serious threat posed by a real and significant doctor shortage,” said AAMC President and CEO Darrell G. Kirch, MD. “With the additional demand from a population that will not only continue to grow but also age considerably over the next 12 years, we must start training more doctors now to meet the needs of our patients in the future.”

Four broad categories — primary care, medical specialties, surgical specialties, and other specialties — are aggregated by the report. In the arena of primary care, there will be a shortage of between 14,800 and 49,300 doctors. In the other three categories, the shortages will be between 33,800 and 72,700 physicians. Moreover, these shortages will persist, despite changes in health care delivery and the usage of other specializations to fill in the gaps.

As Kirch notes, population matters. America’s overall population is expected to grow 11% by 2030, but the over-65 population will surge by 50%. Furthermore, 33% of currently active doctors will also be 65 year of age or older.

When they decide to retire may affect the shortage more than any other factor.

On the other end of the equation, fewer Americans are interested in becoming doctors. “There are definitely fewer people going to [medical school] and more going into careers like engineering,” said Craig Fowler, regional VP of The Medicus Firm, a national physician search and consulting agency. Fowler further notes that Millennials prefer urban lifestyles that don’t align with the limited residency choices available to new medical school graduates.

Thus, rural America is where the doctor shortage is most acute. “As of June 30, according to the federal Health Resources and Services Administration, there were more than 7,200 designated Health Professional Shortage Areas lacking adequate primary care nationwide — home to 85.5 million people,” U.S. News and World Report reveals. “Of those areas, according to the HRSA, nearly 60 percent were in rural regions, and the nation needed 4,022 rural doctors to close the gap.”

Yet Millennial lifestyle choices aren’t wholly selfish. Median medical school debt approaches $195,000 and the higher salaries one can command in urban settings makes it easier to pay off. So does opting for a specialty instead of becoming a primary care provider (PCP).

Ideas such as free tuition and/or arrangements to pay tuition in exchange for working as a PCP in underserved areas have been implemented. But as Dr. Julie Phillips, a PCP and Michigan State University associate professor who researches the consequences of medical student debt, notes, the specialist-to-primary pay gap, coupled with specialists’ shorter working hours and the “prestige factor,” seriously mitigate the effects of those ideas.

Just as disturbing? Those who make it through the rigors and expenses of medical school — and opt out for another career. Fowler cites the insufficient number of residency slots for medical grads. “So you have that population of people who have an MD but didn’t practice for that reason. There is this bottleneck effect,” he explains.

Columnist Cal Thomas’s longtime family physician, Dr. John Curry, now retired, illuminates a far more serious problem. Curry explains that medicine as he practiced it back in 1974 was a transaction between patients and a professional, dedicated class of doctors who took the Hippocratic Oath very seriously. And while there was an assortment of incompetents in the field, “the typical physician put the patient’s interests ahead of his own; everyone who needed care received it; and in dealing with the poor, ‘fees’ could be embarrassingly small,” he explained.

Today? Doctors have been supplanted by “corporate entities” that control everything from hospitals, health insurance, and pharmaceuticals to psychiatric and physical therapy benefits, all for millions of people paying exorbitant premiums. People with little knowledge of how their money is spent.

Government worsens the system via a series of interconnected computers forever being upgraded to deliver better care that never gets better. And physicians who used to be the essence of medical care are reduced to the proverbial cogs in the machine. Curry concludes, “Becoming a physician no longer has the appeal of joining a profession in which one can expect to do a lot of good in the world, advance scientific knowledge, have a lifestyle that balances work and family and earn a better-than-average living.”

Cog in the machine is a recurring theme. Dr. Amy Baxter, who quit medicine after a 20-year career, has little use for the government-mandated expansion of electronic health records (EHRs) engendered by the Health Information Technology for Economic and Clinical Health Act passed in 2009. “With the [enforcement] of EHRs, I had to spend more time as a scribe,” Baxter explains. “One night a child I was treating had a seizure and I couldn’t get the medicine to enable them to breathe because their chart wasn’t in the system yet. This kid was fixing to die and I, the doctor, couldn’t get the medicine. It was demoralizing.”

Baxter is not alone. New research by Stanford Medicine conducted by The Harris Poll reveals a whopping 59% of physicians believe EHRs “need a complete overhaul,” and 40% believe “there are more challenges with EHRs than benefits.”

Far worse, 69% say that EHRs “take valuable time away from their patients.”

Columnist Selwyn Duke cites another factor for the doctor shortage: diminishing faith. While Christianity “stresses self-sacrifice and service to others,” the nation’s increasing infatuation with moral relativism and secularity have produced legions of Americans who embrace self-gratification above all. “Unfortunately,” he asserts, “this decline in faith, and its attendant morality, leads to bigger government.”

Duke is spot on. Despite the evident disaster socialism represents, 70% of Americans, including 52% of Republicans, want Medicare for All.

That so many Americans remain utterly oblivious to the astronomical costs of such a program, and the reality of placing their lives in the hands of bureaucrats instead of doctors, is a testament to the disaster our education system has become.

Another inconvenient reality? More doctors are refusing to accept Medicare due to its low reimbursement rates. Combine that with the increasing doctor shortage and what do you get? What America’s veterans dealing with a health-care-for-all VA already know: Everyone gets health insurance — but one may literally die waiting to get health care.

“In 2017, the U.S. spent $3.4 trillion on healthcare for 323 million Americans, or $10,526 for every man, woman and child,” explains retired pediatric cardiologist Dr. Deane Waldman. “Imagine if every family of four put $42,105 in an HSA every year and simply shopped for and paid for their health care. No government stealing our money to pay its bureaucracy. No insurance company delaying or denying care. Just the old but right doctor-patient relationship with no one and nothing in between.”

Nothing but cultivated ignorance.