Summary
-State, or federally-funded universal insurance willl continue to exist in a vacuum until it is coupled with fixes for other illls of the health care system. These fixes might include tort reform, or subsidized malpractice coverage for physician practices. -Universal health insurance is not enough to fix the problem of physician access. -Primary care will continue to be a problem as long as physician reimbursement continues to dwindle. -The Massachusetts experience is a lesson in health care economics, one that should be carefully studied before investing in a national universal health care system
Analysis
It is no surprise that newly insured Massachusetts residents are facing limited access to health care. The average primary care office is suffering from dwindling revenues due to physician payment cuts, rising practice expenses, and rising medicolegal costs. The bottom line is that for most mature practices, accepting new patients is not an attractive proposition, especially if their insurance pays at or less than Medicare rates.
Insured patients will continue to face access barriers until the financial conditions for primary care improve.
How about nationally-subsidized malpractice coverage for physicians in shortage, to be tied to federally-funded programs such as Medicare or Medcaid, or to a national universal health care insurance program? This will rescue physician practices from the added expense of malpractice premiums, and guarantee access to patients carrying these forms of insurance.
