The Big Dig-ization of Universal Coverage


Aside from recklessly underestimating the number of uninsured in the state, and mischaracterizing their degree of need, Massachusetts is now realizing that you can't have health care without doctors.

“It is a fundamental truth — which we are learning the hard way in Massachusetts — that comprehensive health care reform cannot work without appropriate access to primary care physicians and providers,” Dr. Bruce Auerbach, the president-elect of the Massachusetts Medical Society, told Congress in February, according to the Times.

“It’s a recipe for disaster,” another doctor told the Times. “It’s great that people have access to health care, but now we’ve got to find a way to give them access to preventive services. The point of this legislation was not to get people episodic care.”

There doesn't seem to be any incentive for doctors to go into primary care. 

Primary care doctors typically fall at the bottom of the medical income scale, with average salaries in the range of $160,000 to $175,000 (compared with $410,000 for orthopedic surgeons and $380,000 for radiologists). In rural Massachusetts, where reimbursement rates are relatively low, some physicians are earning as little as $70,000 after 20 years of practice.

One doctor put it like this: “I calculated that every time I have a Medicare patient it’s like handing them a $20 bill when they leave.  I never went into medicine to get rich, but I never expected to feel as disrespected as I feel. Where is the incentive for a practice like ours?”
 
In order to coax more med students into primary care the state has passed costly legislation to erase med school debt for those willing to practice in underserved areas.

Obviously, "fundamental truths" in the health care equation were ignored for political expediency.  When the roof collapses on this thing, it's going to be a lot worse than the Ted Williams tunnel.

 
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