As Senator Barack Obama puts it when talking about health care reform, “If it was easy, we’d have done it by now.” For proof of how complex things can be, take a look at Massachusetts. Insurance agent Bruce Benton passed along a New York Times article describing the challenges some patients in the state face in finding a family physician.
Massachusetts’ health care reform plan strives for universal coverage. Since being implemented last year, about 340,000 of the 600,000 uninsured in the state have gained coverage. The strain on the state’s budget was widely anticipated. Of the newly insured, 176,000 have government-subsidized coverage and another 55,000 have enrolled in Medicaid according to The Boston Globe. The strain on the state’s budget is serious. But again, these kind of cost problems were predictable and aren’t really surprising.
What was apparently overlooked was how the influx of newly insureds into the system is straining the pressure on family doctors and other primary care physicians. As a result there’s waiting lists for some non-emergency treatment that stretches for months in some communities. The Times article recounts one physician in Amherst that is now scheduling physicals for early May — of 2009.
The problem is a serious one. By coming into the system, through subsidized coverage or not, residents of Massachusetts anticipated having access to basic health care services. Yet there’s just not enough primary care physicians to go around.
The United States will need 40 percent more primary care doctors by 2020, according to the American College of Physicians, to accommodate the aging population. It’s hard to see where they’re going to come from. The reasons are many. As the Times story reports, factors include reimbursement rates by Medicaid, and the attraction of a specialist’s practice among them. What’s ironic is that Massachusetts ranks significantly above the average in the per capita number of all doctors and primary care physicians.
Which does one little good if you need a doctor and can’t get one to see you. And none of this means attempts to achieve universal coverage should stop. It just underscores how tough a challenge it will be to make any reform package work.