Massachusetts Insurance Mandate Is Causing Longer Wait Times and Physician Shortage

Published December 1, 2008

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, according to figures provided by the Massachusetts Medical Society in its monthly publication, Vital Signs.

“More than 340,000 Massachusetts residents have gained health insurance since 2006 under the state’s landmark health care reform law,” said the report, which added, “Employers, insurers, providers, and patients have all done their part to make health care reform a success.

“However,” the medical society’s report continued, “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, according to the report.

The Bay State’s attempt at health care reform is “highlighting a shortage of physicians,” wrote Dr. Bruce S. Auerbach, president of the Massachusetts Medical Society, in Vital Signs. “There are now people with insurance who can’t find a doctor.”

Socialization Leads to Rationing

“Socialized medicine tends to lead to waiting lines and rationing,” said Merrill Matthews, a visiting fellow with the Institute for Policy Innovation. “The Massachusetts legislation has dramatically increased the number of people with coverage who now want to see a doctor. That’s exactly what you would expect to happen.”

“The silver lining to the data is that 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,” said Jim Stergios, executive director of the Massachusetts-based Pioneer Institute.

“That has the effect of engaging these individuals in thinking about their health and seeking preventive care, which can lead to less-expensive outcomes,” Stergios said.

Lowering Quality of Care

A sudden glut of newly insured does contribute to problems, Stergios acknowledged. “Increased waiting times may actually dissuade patients from seeing their doctors, which in some cases could lead to lower quality care,” he said, “and there may also be a bidding up of overall costs.”
“Massachusetts is demonstrating what would happen if a national health care system were ever to become law in the United States,” said Twila Brase, president of the Citizens’ Council on Health Care. “Entitlement and so-called ‘universal coverage’ led to a surge in utilization which resulted in physician shortages” in the Bay State, she noted.

Strains on Doctors

The problem of patient overload of the system is being compounded by doctors leaving the state to work elsewhere, said Stergios.

“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 our doctors to practice medicine in states that are less restrictive,” Stergios noted.

“Doctors are moving to areas outside of Massachusetts because of fewer restrictions on how they practice medicine, lower costs of practicing medicine, and lower cost of living,” Stergios said.

Dr. Sanjit Bagchi ([email protected]) writes from India.

For more information …

“Physicians and Patients Grappling with Access Challenges as Newly Insured Enter the System,” Vital Signs, Massachusetts Medical Society, September 2008: