Physician Wait Times and Health Reform

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:

Source: The New Republic


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.
-Brian Rosman

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2 Responses to Physician Wait Times and Health Reform

  1. Matt says:

    Seriously? No mention of the fact that emergency usage has not gone down? Or than costs have increased dramatically? Here is what YOU said:

    “The new health reform law merges the individual and small group markets, expected to bring premiums down by as much as 25% for individuals, while raising them 2% to 3% for small groups. The legislation encourages tighter networks, which may also bring down costs. And, the biggest thing the Legislature did to bring down premiums was to require that everyone get insurance. We did not ask for, or endorse the individual mandate, but it will bring more young and healthy people into the market, improve the risk pool, and bring costs down for everyone.”

    http://blog.hcfama.org/2006/04/24/mitt-under-attack-by-wall-street-journal-defended-by-hcfa/

    You also wrote:

    ” The real verdict on this law won’t be known for 3-5 years after serious implementation work. We’ll be working our butts off to implement it as well as possible. ”

    http://blog.hcfama.org/2006/04/17/can-they-be-talking-about-the-same-law-adventures-in-post-modernism-ii/

    By your own timeframe, this IS the real verdict! Costs are up, wait times are up, energency room usage is constant, the budget is getting busted. Basically, you failed.

    What exactly is you excuse now?

  2. Amanda says:

    Just wait until Obamacare’s mandate kicks in.
    You’ll have many people being forced to buy insurance. Do you really think that after being forced to buy insurance, healthy people would not run to the nearest doctor’s office for the slightest backache, or sniffle? Think again.

    I did a lot of yardwork over the weekend, and woke up with a mild backache on Monday (gone completely now). I didn’t tie up the medical system for nothing, choosing to save money (I have no insurance by choice). You can bet your bottom dollar that, after having a mandate shoved down my throat, I will have made SEVERAL Chiropractic visits by now.

    Where will that leave you overweight DM cases and patients with hx of MI, when you have to run to the doctor, and can’t be seen for days?

    Satisfied now?

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