Physicians and patients grapple with access challenges

The dramatic increase in the insured population that followed Massachusetts's imposition of an individual health insurance mandate has caused an increase in average wait times to see primary care physicians and has resulted in doctors leaving the state, according to the Massachusetts Medical Society.

Researchers found that:

  • More than 340,000 Massachusetts residents have gained health insurance since 2006 under the state's landmark health care reform law, and employers, insurers, providers and patients have all done their part to make healthcare reform a success.
  • However, interviews with primary care physicians across the Commonwealth suggest that many of those newly insured people are having trouble finding a doctor.
  • The current average wait time to see a primary care physician in Massachusetts is 36 days, up from 34 days in 2007, and increased waiting times have dissuaded patients from seeing their doctors.

    Overall, Massachusetts is demonstrating what would happen if a national health care system were ever to become law in the United States. Entitlement and so-called "universal coverage" led to a surge in utilisation which resulted in physician shortages, says researchers.

    However, there is a silver lining, say researchers: more people are getting coverage and, more importantly, many thousands are buying insurance through the private market rather than receiving it as a purely public handout. This has the effect of engaging these individuals in thinking about their health and seeking preventive care, which can lead to less expensive outcomes.

    Yet, the problem of patient overload of the system is being compounded by doctors leaving the state to work elsewhere, says researchers. The strains on doctors who already have higher tort claim costs and face numerous requirements from the state government and insurers may lead even more of them to practice medicine in states that are less restrictive.

    Source: Sanjit Bachi, Massachusetts Insurance Mandate Is Causing Longer Wait Times and Physician Shortage, Health Care News (Heartland Institute), December 2008; based upon: Physicians and Patients Grappling with Access Challenges as Newly Insured Enter the System, Vital Signs (Massachusetts Medical Society), September 2008.

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    FMF Policy Bulletin/ 17 December 2008
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