Massachusetts Universal Health Care: Problems and Solutions

In 2006, Massachusetts passed a law with the goal of making sure every resident of the state had health insurance. Today, the state has almost reached that goal, as 97% of Massachusetts residents have health insurance. That is the highest percentage in the country.

In Massachusetts, all residents are required to buy insurance or pay a tax penalty. The insurance is offered through an independent public organization called Commonwealth Care. One of my relatives lives in Massachusetts, and she gave the system rave reviews. She got to choose her own doctor, her health care costs were much lower, and she can’t think of many bad things to say about it. She only says that some people didn’t understand how to use the system because it was complicated.

Although some have had a great experience with the system, there are some problems that need to be addressed. Firstly, there is an average wait time of 36 to 50 days for new patients, and around half of internal medicine physicians are not accepting new patients. This is according to an editorial on cnn.com, which cites the Massachusetts Medical Society as the source of these statistics. The editorial also points out that there has been a 7% increase in emergency room usage, and if this system was national the wait times would be worse, because Massachusetts has the highest concentration of doctors in the nation.

Secondly, there is the cost. “The program is broke. Part of it is because of recession, part of it is because there’s no cost controls,” Democratic Party Chairman Howard Dean said on NPR Tuesday night. Dean said that to combat the cost issue, Massachusetts should be moving toward a system of global medical payments.

Under a global payment system, doctors would be paid a fixed price for routine medical care over a given period of time, instead of paying doctors for individual procedures. This would mean doctors would no longer have a financial incentive to perform unnecessary treatments and tests. On the other hand, it might also give them a financial incentive to cut corners on borderline situations.

Insurance companies will set budgets for doctors, if the doctors are under budget they and the insurance company will pocket some of the savings. If they go over budget, the insurance companies and health care providers will cover the excess. In theory, this excess will be covered by other patients who are under budget, and it will all even out.

Either way, a global payment system is not going to solve the cost problem in the short run, it is meant to benefit in the long run. For more on the potential global payment system in Massachusetts, read this article.