Predictably, all those who never liked Massachusetts health reform are piling on with the release of a report from the Mass Medical Society on wait times for physicians appointments. The report shows mixed results. The average wait time for an appointment for internal medicine is five days shorter than last year, the wait time for family medicine is 7 days longer, and for pediatricians, the wait time is unchanged.
But that doesn’t stop “analysts” like the Herald’s Michael Graham to proclaim, “Romneycare proves failure.” Similar articles appeared in the right-wing press, like the Wall Street Journal, National Review, etc.
Today, The New Republic’s health policy blogger Jonathan Cohn reviews the evidence and punctures the conclusions. His piece, Defending Romneycare (Because Romney Won’t Do It), includes a helpful chart, too:
[T]he report tells a far more complicated story, one that may not have much (if anything) to do with health care reform. …
While the long waits for physician services in Massachusetts seem real enough, the very same survey reveals that the long waits existed before Romney’s law took effect in January, 2007. You can see for yourself in the following graph, which documents the trend for physicians of internal medicine:
It’s hard to spot a clear trend here, particularly if you discount that 2006 figure as an anomaly. It’s even harder to spot a clear trend if you go through the report and examine the responses from other types of doctors. Reported wait times go up and down, year to year, which is precisely the sort of statistical noise you’d expect from a survey that relies on small samples size and the non-scientific testimony from physicians. Evidence of longer waiting times since the introduction of Romney’s plan seems thin, at best.
We would add that the next phase of health reform – payment reform – is intended to deal with many of the care availability issues that are issues throughout the country. We get what we pay for. The current fee for service reimbursement system best rewards specialty care and complex procedures. Primary care is poorly paid for, and many services that keep patients healthy are not paid for at all. Under payment reform, practices organized as medical homes will focus on primary care, and their payments will be tied to having care accessible.
We should view the Medical Society’s report as a spur to move quicker to making the improvements we know are needed to help patients access care.