TNew Mexico can't keep its doctors.

This has long been a problem for smaller communities and in the last five years, our largest metro area, Albuquerque, is also seeing its physicians flee the state.

And it isn't just specialty care. Primary care physicians have also left – 700 of them since 2017 - leaving the state below national provider-to-population benchmarks. This isn't a looming danger. It's a crisis we are in now that will take years to recover from.

It's a grave crisis because of our population. In the last decade our population barely grew. But that growth came from people over the age of 64. The only group of people coming to New Mexico are retirees – the demographic needing significantly more healthcare services than any other.

18.5% of New Mexicans were over 65 in the 2020 census. This number is projected to be 26.5% by 2030. Nationally, the over-65 population is projected to be 19.7% by 2030. Our working population is leaving the state for better career opportunities due to our flatline economy.

I might note here it is already 2023.

It's been well reported what is contributing to the rapid exodus of our doctors: the business and regulatory climate in our state. Man, am I tired of writing about how unfriendly our state is to business. But we're not talking about filthy capitalists, if that's how you choose to look at the private sector, or even the mom-and-pop small businesses that the state continues to screw over decade after decade.

Its our doctors. Doctors in New Mexico can roughly double their take home pay in any of our neighboring states. Malpractice insurance here costs three times as much as in other states because of our high malpractice damage caps.

Add to that the fact that New Mexico has the highest Medicaid enrollment in the region, and the lowest Medicaid reimbursement rates. Then the state imposes gross receipts tax – essentially a sales tax – on medical services. Only three other states tax medical services, and generally under much greater restrictions that we do. None of them is in the Southwest.

Add to that the other challenges facing physicians' families and spouses: poorly performing public schools, rising crime in urban areas, and limited work opportunities and amenities in rural areas.

The Legislature has a number of bills pending to address some of these issues. However, there are two weeks left in the session, so we will get what we get from our part time, unpaid legislators.

There is funding in the budget bill to bring reimbursement of Medicaid services to 100% of Medicare rates, and 120% of Medicare rates in certain areas like behavioral health. According to the Albuquerque Journal, 72% of babies born in New Mexico are born under Medicaid coverage, the highest rate in the nation.

It remains to be seen whether any of the malpractice reform bills will get out of committee before the session ends. Republicans have taken the lead on this crucial topic, but Democrats seem unwilling to back away from their 2021 malpractice cap increase.

There is also a bill, House Bill 209, which would offer assistance to physicians in repaying their student loans, requiring them to practice in the state for three years after accepting assistance. I think this is an expensive band-aid – three years does not a medical career make, and without malpractice and GRT reform, we won't keep physicians longer than the three-year payback period.

If we don't quickly reverse our physician exodus, our retirees who can leave will be forced to leave the state, meaning our young and old people will leave simultaneously. Expect population loss in the 2030 census.

I think more people under 65 planning for retirement may think twice about staying here. I have the benefit of excellent insurance and already leave the state for treatment for my chronic condition because it is simply impossible to access subspecialty care here. Many more patients leave their symptoms untreated for too long for lack of care.

Suddenly, Tucson or Lubbock or Colorado Springs hold a lot of appeal.

If we start losing more of the 45–64-year-old workforce, I think it could be a true death knell for our state. We will be the national labs and the people who clean their houses. The senior skill sets will be gone, with no one moving in to replace them, and no industry moving in, because no workers.

New Mexico faces a truly bleak future, not in 20 years, not in 10, but this year as people who will become ill in 2023 must try to get care with 30% fewer physicians.

This is a life-or-death matter for our state. And it will get worse before it gets better.

Merritt Hamilton Allen is a PR executive and former Navy officer. She appears regularly as a panelist on NM PBS and is a frequent guest on News Radio KKOB. A Republican, she lives amicably with her Democratic husband north of I-40 where they run two head of dog, and two of cat. She can be reached at news.ind.merritt@gmail.com.