It may well be true — as the Government Accountability Office contended two months ago — that reports of a shortage in doctors in the United States are greatly exaggerated. But tell that to Massachusetts, where RomneyCare has put a strain on primary-care physicians. Add the cost overruns, the persistence of the underlying inefficiencies of American health care and one sees the downside of the program we called “a Frankenstein monster” in 2006 for its unwieldiness. Less medically endowed states should take note.
It is nearly two years since then-Gov. Mitt Romney signed this experiment into law. Today, a greater number of state residents are now covered: About 340,000 of the 600,000 uninsured in 2007 are covered, which is a significant gain. But the dramatic rise in health care demand has not been met with a co-equal rise in supply of physicians. This has fueled a rise in costs, a resort to nurse practitioners and other non-M.D.s; it has made waits for appointments longer and resulted in other unwanted effects. The surge in demand has stretched the state’s corps of primary-care physicians. This in turn may be pushing more new doctors into specialty medicine. Routine preventive care is likely to remain elusive for most people.
As the New York Times reported this weekend, merely scheduling a physical can mean more than a year’s wait in some parts of Western Massachusetts. The primary-care physician shortage identified by the Massachusetts Medical Society last year continues.
It may well be possible to mitigate these circumstances with the right “supply” incentives. State lawmakers are currently proposing medical-school loan-forgiveness plans to draw primary-care physicians where they are needed, among other measures. But it’s worth noting that RomneyCare has done exceedingly little to correct American health care’s excess costs compared to other advanced economies. Its cost has surged above initial estimates and shows few signs of abating. Overall medical costs continue to skyrocket in ways that threaten competitiveness, social services, pensions and more. If relatively wealthy and medically advanced Massachusetts faces significant difficulties, how much worse will it be in less favorably positioned states?
Sign up for Daily Newsletters
