WASHINGTON — One of the biggest threats to the success of President Obama's health care law comes from shortages of doctors, nurses and other health care professionals. But a 15-member commission created to investigate the problem has never met in two and a half years because it has no money from Congress or the administration.
"It's like 'Waiting for Godot,' " said Dr. Richard D. Krugman, the dean of the University of Colorado Medical School and a member of the commission. "We are sitting on a park bench, waiting for Godot. We'll see if he shows up."
With an aging population and 30 million people expected to gain coverage under Mr. Obama's health care law, the demand for medical care is expected to increase. But Dr. Sheldon M. Retchin, the vice chairman of the panel, the National Health Care Workforce Commission, said, "We are prohibited from meeting and discussing these issues."
Members of the independent nonpartisan panel said they wanted to address these questions: How many more doctors are needed? What is the right mix of primary care physicians and specialists? Who will care for the millions of people gaining Medicaid coverage next year?
Should states rewrite their laws to allow nurse practitioners and physician assistants to do more of the work done by doctors? Could pharmacists play a larger role in coordinating care and managing the use of medications?
The commission was created by the 2010 health care law, the Affordable Care Act. Mr. Obama has requested $3 million for the panel in each of the last two years, and some Democrats, like Senator Tom Harkin of Iowa, chairman of the Appropriations subcommittee on health, have supported the request.
But Republicans in Congress have been reluctant to provide money for anything connected with the law, which they opposed. "Anything authorized in the Affordable Care Act has a tough road with the Republicans," said Dr. Atul Grover, the chief lobbyist for the Association of American Medical Colleges.
The chairman of the commission, Peter I. Buerhaus, a professor of nursing at Vanderbilt University, said: "It's a disappointing situation. The nation's health care work force has many problems that are not being attended to. These problems were apparent before health care reform, and they will be even more pressing after health care reform."
Dr. Krugman said the commission was "caught in a broader political struggle, and in the gridlock between Congress and the administration."
Dr. Retchin, who is the senior vice president for health sciences at Virginia Commonwealth University in Richmond, said "the government needs to analyze the scope, caliber and composition of the health care work force" because labor costs accounted for a large share of the nation's health care bill.
Members of the panel, appointed in September 2010 by the comptroller general of the United States, have no staff, no budget and no agenda.
Kim J. Gillan, the director of the work force training program at Montana State University Billings, said federal officials had made clear to her and other panel members that "we were not to function as a group or have contact with one another."
Ms. Gillan said some people apparently feared that the commission might recommend the national licensing of health care professionals or other steps that could interfere with state prerogatives.
Another panel member, Prof. Thomas C. Ricketts of the University of North Carolina at Chapel Hill, said the Government Accountability Office, an investigative arm of Congress, had advised the panel that "we were not to work or be seen to be working."
Dr. Krugman said, "We were told that we were to have no conversations until we were funded because that would be a violation of some federal law or rule."
Chuck Young, a spokesman for the accountability office, said, "Agencies generally cannot conduct business without an appropriation."
In a summary of research, the Department of Health and Human Services said, "The United States faces shortages of primary care physicians, dentists, nurses and other health professionals."
Roger J. Moncarz, an economist at the Bureau of Labor Statistics, said that employment in health care occupations was expected to grow by 29 percent, with the addition of 3.5 million new jobs from 2010 to 2020. Federal officials expect 712,000 new jobs for registered nurses — more than for any other occupation in the country — and a total of 1.3 million new jobs for home health and personal care aides, he said.
Edward S. Salsberg, the director of the National Center for Health Workforce Analysis at the Health and Human Services Department, said 57 million people were living in areas with shortages of primary care practitioners.
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