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Thursday, May 7, 2009
Doctor Wait Times, Costs, ER Visits in Massachusetts Climb
The best laid schemes o’ mice and men
Gang alt a-gley (go off the planned line)
Robert Burns, 1759-1796
More people are seeking care in Massachusetts hospital emergency rooms, and the cost of caring for ER patients has soared 17% over two years. This is despite efforts to direct patients with nonurgent problems to primary care doctors instead, according to new state data. Visits to Massachusetts emergency rooms grew 7% between 2005 and 2007, to 2,469,295 visits. The estimated cost of treating those patients jumped from $826 million to $973 million.
“ER Visits, Costs in Massachusetts Climb,” Boston Globe, April 24, 2009
Long wait times in Boston may be driven in part by the healthcare reform initiative that was put in place in Massachusetts in 2006. The initiative succeeded in covering many of the state’s uninsured patients. However, it has been reported that many patients in Massachusetts are encountering difficulty in accessing physicians. Long appointmend times in Boston may signal what could happen nationally in the event that access to health care is expanded through healthcare reform. Increased demand resulting from improved access to care for 47 million uninsured people can be expexted to extend doctor appointment wait timen in many markets.
Merritt Hawkins & Associates, “2009 Survey of Physician Appointment Wait Times,” www.merritthawkins.com
Among the political cognoscenti, Massachusetts is considered the Bluest of the Blue States, the Elite of the Elite, the Leaders of the Liberal Health Reform Band. It is the state where President Obama received his law school education, where Senator Edward Kennedy has fought for a single payer system for 40 years, where Obama’s closest health care advisors, Dean David Cutler, PhD, of Harvard and Robert Blumenthal, M.D., of Massachusetts General and National Coordinator for Health Information Technology,reside, and where the nation’s first “universal health plan” was spawned and has been in operation for three years.
Yet, despite this political firepower, something seems to have gone askew. Massachusetts health costs are the highest in the land. Despite the highest concentration of physicians per capita and lowest rate of uninsured among the states (2.6%), people are having a hard time finding doctors, especially primary care practitioners but other specialists as well. Bay State residents are flocking to high-cost emergency rooms for care in unprecedented numbers. And all of this in an affluent states which is supposed to set an example for other states to follow.
The average wait times for appointments in Boston for cardiology are 21 days, dermatology 54 days, obstetrics-gynecology 70 days, orthopedic surgery 40 days, and family practice 63 days.
The average cumulative wait times for the 5 specialties just mentioned are,
Boston, 50 days
Philadelphia, 27 days
Los Angeles, 24 days
Houston, 23 days
Washington, D.C., 23 days
San Diego, 20 days
Minneapolis, 20 days
Dallas, 19 days
New York, 19 days
Denver, 15 days
Miami, 15 days
Portland, 14 days
Seattle, 14 days
Detroit, 12 days
Atlanta, 11 days
Conclusion
In Massachusetts and Boston, expanded access through a near-universal coverage plan has consequences - higher costs, increased ER use, harder times finding doctors, longer waiting times for doctor appointments.
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1 comments:
Thanks for these numbers. They're like a splash of ice water in the face of a drunk.
The MA numbers don't surprise me. My working life was spent managing the "working poor" in the food business and I can assure anyone who wants to know that their concept of health care is light years from the notions of insured people.
Yes, the company had group insurance. My family used it for years. But for people earning only slightly over the minimum wage, many of whom have two jobs and need two or more incomes in every family, insurance premiums (along with routine dental care) are not in the budget. I don't know about other communities, but in Atlanta, Grady Hospital is where they go for serious non-emergency care.
MA is a microcosm of what will happen nationwide when and if universal health care comes about. We can expect a tsunami of demand as long-neglected medical problems present all at once. Aside from the costs, the infrastructure challenge is even more scary. But I think it is a bullet we will have to bite to catch up with other countries.
Speaking of which, one of the criticisms of the Canadian and British systems we often hear is the wait times for certain procedures. That list of wait times you listed for the five specialties is telling. Seems like I never heard those numbers mentioned before. Hmm.
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