Evidence-Based Health Care Reform? Lessons From Massachusetts

In Massachusetts, where 97% of us have health insurance by mandate since 2006, we have learned a few things about health care reform.

We have learned that universal coverage does not mean universal access to a doctor.  The Massachusetts Medical Society reports that there is a critical shortage of family physicians and severe shortage of internal medicine doctors.  Seven physician specialties are also operating in critical or severe physician labor markets.

A recent study by the Robert Wood Johnson Foundation showed that 75% of non-emergency ER visits occurred because a regular physician was not available after hours, and half of these visits occurred because a timely appointment was unavailable.  With more than half of all the doctors trained in Massachusetts leaving the state, citing the practice environment and low salary levels, and one out of every four currently practicing doctors considering a career change, it does not appear that access issues are going to improve soon.

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