Pennsylvanians of all ages will face sharply higher health care costs in a decade unless our state government acts now to increase the number of doctors practicing in our Commonwealth.

One of the most basic rules of economics is that prices rise when there's low supply and high demand. Unfortunately, Pennsylvania will face a high "demand" for doctors at the same time that we are struggling to increase the "supply" of physicians.

Right now, we are not recruiting or retaining enough doctors to meet our growing health-care needs. While it might not be a full-blown crisis now, within the next 10 years, we will have fewer doctors and more consumers of health care.

There are three reasons why this problem exists.

First, Pennsylvania has one of the largest and fastest-growing populations of elderly in the country. As this population increases, so will their health care needs. Simultaneously, our doctors are getting older and planning to retire. According to the Pennsylvania Department of Health (DOH), 41 percent of practicing doctors in Pennsylvania plan to retire in the next ten years and half of them plan to retire in the next five years.

Second, according to recent DOH statistics, just 3 percent of the doctors practicing in Pennsylvania are under the age of 35. With the retirement of nearly half of our doctors coming and very few young doctors currently in our medical system, it's like having a veteran baseball team with no farm system.

Third, and perhaps most importantly, we are not on track to increase the number of young doctors practicing in Pennsylvania. Pennsylvania boasts one of the largest concentrations of medical school students in the nation but we have trouble retaining these medical residents after they complete their training. While the number of medical residents training in Pennsylvania has increased in the past decade, the number of residents staying in Pennsylvania to practice medicine has decreased significantly. In 1994, 50 percent of the medical residents who trained in Pennsylvania stayed here to practice; just 10 years later, less than 8 percent stayed after completing medical school. The shortage of doctors is especially acute with primary care doctors and OB/GYNs.

Smart government looks to the future to anticipate problems before they become crises. If we as a community want to protect ourselves from even higher health care costs in a decade, now is the time to act to provide incentives for doctors to practice in Pennsylvania. In an effort to do just that, I introduced legislation to establish a loan forgiveness program for physicians who agree to practice in Pennsylvania for a decade.

Under my legislation ( H.B. 1093), primary care physicians and OB/GYNs would receive 100 percent medical school loan forgiveness in exchange for agreeing to practice medicine in Pennsylvania for at least 10 years. Participating doctors would receive a portion of their loan repayment for each year that they stay in Pennsylvania. If they leave the state before fulfilling their entire 10 year commitment, they would have to repay the state any money they received. Statistics show that doctors who practice for at least 10 years are likely stay in Pennsylvania to practice permanently, making the investment of tax dollars worthwhile.

The state has an important role to play in mitigating the overall health care crisis. While there may be many reasons for the impending crisis that must be addressed over the long term, we can not shy away from addressing a part of the problem that is fixable today. The fact that in 10 years health care costs will soar and we will not have enough doctors to care for us requires the attention of government today. We must act now to sustain the availability of high quality health care in Pennsylvania.

Rep. Josh Shapiro is the Deputy Speaker of the Pennsylvania House of Representatives and represents the 153rd Legislative District in Montgomery County.