Expanded Coverage = Less Access to Care

I've always said that the closer the state gets to "guaranteeing" "universal" coverage, actual access to care decreases. This has been the case in Massachusetts, since the 2006 reform that mandated health insurance for all.


A recent white paper by the New England Healthcare Institute suggests that access to primary care in Massachusetts is actually worse than in other states, where health insurance is voluntary. Remaking Primary Care: From Crisis to Opportunity, reports data from the Massachusetts Medical Society. The share of primary-care practices accepting new patients dropped significantly from 2006 to 2008: 90% to 78% in pediatrics, 69% to 52% in internal medicine, and 75% to 65% in family medicine (p. 13, figure 3).


However, the same page cites a national survey with data from 2003-2004, that 94% of primary-care practices were accepting new patients. However, only 74% were accepting new Medicare patients, and only 64% were accepting new Medicaid patients (footnote 20).


The message is pretty clear: more government coverage equals less access to care.