I am writing this column from another state where I am currently undergoing a course of medical treatment. When this medical issue arose earlier this summer, I was told flat out by my Albuquerque primary care provider that getting a consult to this particular specialty in New Mexico’s largest city would take a year. So here I am in Minnesota.
We have all felt the pinch as health care providers have left our state. Think New Mexico, the state’s leading non-partisan think tank, just released a new report on the issue. According to the report, more than one in three New Mexico counties no longer have hospital-based maternity care, meaning expectant mothers must take to the open highways to deliver their babies safely in a hospital.
The report cites more disturbing statistics. Our healthcare provider shortfalls are profound: we come up 30% short for nurses, almost 19% for primary care physicians, 25% short for OB-GYNs, 35% short for psychiatrists. One number is shocking: we have a 73% shortfall statewide for EMTs.
These shortages are compounded by many factors, including the age of our physician population (roughly 40% of our doctors are expected to retire by 2030), the dispersion of our healthcare providers across the state (every county except Los Alamos County has a provider shortage), and the age and comparatively poor health of New Mexicans (one in four New Mexicans will be 65 or older by 2040).
There is a cure for some of these ills.
Think New Mexico is really good at solving statewide problems. Think New Mexico is in its 25th year and counts among its dozens of positive policy results the repeal of the state tax on food; enhancing the training and transparency of local school boards; reforming title insurance to lower closing costs for homebuyers; making the state’s infrastructure spending transparent by naming the legislative sponsors of every capital project; and repealing the state tax on Social Security for middle and lower income New Mexicans.
Think New Mexico has several common-sense solutions to address our healthcare provider shortage. They involve making it easier and more cost-effective to be a healthcare provider in New Mexico; growing of our own healthcare workers here in New Mexico; bringing in more international physicians; and creating a permanent fund to pay for these reforms while the state is flush with cash.
Perhaps the area in greatest need of reform is New Mexico’s Medical Malpractice Act. Simply put, New Mexico’s malpractice premiums are among the highest in the nation and rising at rates approaching 150% over the last three years. New Mexico’s Medical Malpractice Act, badly needing reform, represents a perfect storm of loopholes that make New Mexico a great place to file a lawsuit and a lousy place to open a medical practice.
Think New Mexico recommends six reforms to bring our Medical Malpractice Act into best practices as evinced by other states. First, it recommends a reasonable cap on attorney’s fees. Next, end lump-sum payouts from the Patients’ Compensation Fund (up to 40% of which comes off the top to the lawyers) and instead make payouts as costs are incurred by the patient.
The next recommendation is to stop venue shopping; as an example, a $68 million verdict against a Gallup hospital was not filed in the county it was located in, but in the First Judicial District in Santa Fe, which is known for being more generous to plaintiffs. A local jury might not have made an award that was so likely to close their local hospital.
The remaining malpractice reforms involve changing the standards of proof for punitive damages, prohibiting multiple lawsuits over a single malpractice incident, and requiring that damages awarded for future medical costs reflect the actual cost of care. These reforms are all intended to reduce the malpractice insurance loss ratio in the state – the amount of money malpractice insurers pay out in claims that exceeds the amount they are receiving in premiums.
The next major area for reform involves making it easier to work in New Mexico. There are ten major interstate agreements for healthcare licensure; New Mexico only belongs to one. Colorado belongs to all ten. Only four other states belong to two or fewer of these agreements, or compacts. Healthcare workers moving to states belonging to these compacts do not have to reapply to be licensed in their new state.
The last legislative effort to bring New Mexico into these compacts in 2023 ended when the bill failed to receive a hearing from the House Judiciary Committee. Opponents of the interstate credentialing proposal argue that adopting them would allow other states to decide who gets to practice medicine and therefore harm state sovereignty. Phooey.
Think New Mexico also recommends establishing a centralized credentialing system to be used by all insurers and healthcare delivery systems; expansion of the Health Professional Student Loan Program; a permanent repeal of GRT on medical services; and expansion of the Rural Health Care Practitioner Tax Credit.
The next reform is challenging: Medicaid reimbursement. More than four out of ten New Mexicans is on Medicaid. Medicaid is a federal-state partnership, and the state determines the rate of reimbursement to providers for Medicaid patients, even though New Mexico only provides 20% of Medicaid funding (the federal government pays the remaining 80%). Generally, Medicaid reimbursement is benchmarked against Medicare reimbursement rates, and some proposals recommend taking Medicaid reimbursement as high as 250% of Medicare reimbursement rates.
This will be expensive for the state and the nation in the long term, but with more than 40% of our population enrolled it seems crucial to increase reimbursement rates to a certain level to retain the medical providers required to care for them.
Think New Mexico notes in its report that the best way to retain healthcare workers is to “grow our own.” It recommends increasing Career and Technical Education programs in public schools and incentivizing hospitals and medical centers that support these programs by offering liability protections, with the goal to creating more employment certifications, particularly EMT certifications, out of our high schools.
Think New Mexico has also noted a significant salary gap between the physicians and nurses who serve as medical and nursing school faculty in New Mexico and doctors and nurses in private practices. It recommends closing this pay gap and also providing a tax credit for the fully trained professionals who donate their time to provide on-the-job training to healthcare students. More common sense.
Think New Mexico recommends the Legislature consider permitting internationally-trained physicians to apply for a provisional license without completing a residency in the U.S. These physicians would practice under the supervision of a New Mexico physician and upon successful completion of the provisional period be eligible to apply for a permanent license. Tennessee, Florida, Illinois and Virginia have all enacted such legislation and similar bills have been introduced in seven other states.
The final recommendation is the establishment of a $2 billion permanent fund out of budget surplus to cover the cost of these reforms in perpetuity.
Unlike this columnist, Think New Mexico does more than write about New Mexico’s hardest problems; it develops sensible fixes for them. You can download the report I have referenced in this piece and learn about their other work at www.thinknewmexico.org . You can also make a tax-deductible donation. Your donation can be assured to go toward thoughtful policymaking, a refreshing change in today’s polarized times.
Merritt Hamilton Allen is a PR executive and former Navy officer. She appeared regularly as a panelist on NM PBS and is a frequent guest on News Radio KKOB. A Republican for 36 years, she became an independent upon reading the 2024 Republican platform. She lives amicably with her Democratic husband north of I-40 where they run one head of dog, and two of cat. She can be reached at
