Last year, revolutionary legislation went into effect in Massachusetts mandating health coverage for all citizens of the Bay State. Because universal health coverage is one of would-be President Barack Obama’s big tickets, this might qualify as a teachable moment. The state of Massachusetts, acting as a “laboratory of democracy,” has done the rest of America a huge favor by giving an early look at some of the benefits of government medicine, as well as the unintended consequences.
One consequence of the state law requiring everyone to have health insurance – hundreds of thousands of people suddenly need a routine physical. According to the New York Times, about 340,000 of Massachusetts’ uninsured citizens have gained coverage so far. That’s over 300,000 people calling doctors to make appointments for a check up. Of course, there aren’t magically 300,000 new doctors in Massachusetts, so the waiting list for an office visit might be a few months. On the upside, it’s a free physical. In October, if you’re lucky.
In the private market, increasing demand for any good or service has the effect of increasing that good/service’s price, but also decreasing the relative quality of that good/service. Long waiting lists are part of that degradation in quality, and there’s no sign that demand will slow down. And what happens if there’s a sudden influx of uninsured Massachusetts residents? In the 1970’s, Wisconsin became a welfare magnet because it paid higher benefits than other states. On the upside, it’s free.
Another example of degradation in quality – despite the good intent behind the law, uninsured people aren’t guaranteed access to primary care physicians. Because of skyrocketing demand, many doctors are declining to accept new patients, meaning newly insured persons might have to travel 20+ miles from their homes to see a doctor. Unless of course they’re willing to go on the waiting list with a closer doctor. On the upside, it’s free.
However, possibly the most regrettable unintended consequence is the potential decline in job satisfaction among physicians. The New York Times highlights this aspect:
Dr. Atkinson, 45, said she paid herself a salary of $110,000 last year. Her insurance reimbursements often do not cover her costs, she said.
“I calculated that every time I have a Medicare patient it’s like handing them a $20 bill when they leave,” she said. “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?”
Medical students won’t become primary care physicians if it’s thankless work, especially when they can make more as specialists. On the upside, it’s free.