The coronavirus pandemic has torn through the American health care system and laid bare a critical shortage of workers. Hospitals have called upon retired physicians, nurses, and imported professionals from out of state to bridge the gap. Still, these measures will do little to address the root causes of the low national doctor-patient ratios. The system now seen struggling under the weight of COVID-19 has been long in the making.

Among the 36 OECD countries, the U.S. has, for years, sat near the bottom 25th percentile in physicians per capita. Some estimate the doctor shortage could reach approximately 122,000 clinicians by 2032. While some may point fingers at the “flaws” in America’s free market-driven health care system, consumers really have bureaucrats and politicians to thank for these lackluster numbers.

Monopoly powers, bequeathed to the medical community by politicians, is one of the major factors driving the dearth of medical practitioners. Currently, the American Medical Association (AMA), which spent over $20 million in lobbying last year, controls state licensing boards in all 50 states. In the name of safety and wellbeing, it imposes licensing quotas and arbitrary caps to restrict the number of healthcare professionals and facilities that operate in each marketplace.

Beyond artificial restraints, market factors are shrinking the physician population. Dwindling hospital revenues stemming from Washington, D.C.’s out-of-order funding priorities, out of control medical malpractice liability caused by Congress’ years of dragging its feet, and increased government intrusion into the doctor-patient relationship make the field an undesirable choice for young and old alike.

Despite all these facts, little has been done to reform our system. Recalcitrant politicians forge blindly ahead with mandates that further exacerbate the problems at hand.

The outcomes of such folly are already on vivid display at the Indian Health Services (IHS). Even though the causes may be different, the consequences should be a warning to leaders.

IHS, the agency responsible for much of Native American medical care, has faced significant staffing shortages for years. A quarter of its positions remain vacant, and desperation often forces the hiring of problematic physicians – even some with reckless histories. It’s little wonder that those using IHS hospitals have a mortality rate for chronic preventable diseases that’s 3-5 times higher than the rest of the country.

Limited resources are the foundation of shortfalls in tribal healthcare. Congress appropriates funds for medical care and other programs to help overcome ills created by the U.S. government’s previous systematic decimation of these societies, but the allocations rarely meet the needs. Counterfeit groups aggravate the scarcity when they compete for funding.

The Los Angeles Times recently chronicled the extent of this problem in an article that highlighted the hundreds of millions of dollars flowing to factions not recognized by the federal government, leaving legitimate tribes short-changed. These organizations, and their money, are politically popular in state legislatures and often achieve recognition under few standards and little scrutiny.

Ever ready to make a bad situation worse, Congress is now even poised to grant nation status to a group of people in North Carolina that have claimed, but never proven, native ancestry. The so-called Lumbee Tribe is already siphoning tens of millions of dollars in federal contracts away from legitimate tribes. Congressional recognition of this group will lower the standard and set the stage for hundreds of similar groups to follow, worsening the Indian funding problem.

Like the doctor shortages at IHS, Congress can address the lack of doctors in America. Rather than making the issues worse, it should eliminate outdated regulations and enact policies that incentivize people to join the healthcare profession. It should prioritize health care funding to those who genuinely need it – not just those who can flex political power.

The Washington, D.C. bureaucracy avoided such reforms before the pandemic hit. If nothing else, the cascading failures of our current system should make it clear that this area of improvement should be a top priority. The next mammoth rescue package presents another opportunity to rise above previous failures and begin to work towards permanent solutions. But as the past is prologue, it would not be wise to wager on it.

Benjamin Alli, M.D., Ph.D., is a Sakellarides professor of medicine and surgery and the chancellor of the Royal College of Physicians and Surgeons of the United States of America.