Yes I am for universal health care but manadatory health care insurance does reveal an underlying problem with the health care system overall -a shortage of health care providers. This has become clear in Massachusetts where I live, since the state government mandated that everyone take out health insurance. A close friend recently had to look for another provider when hers left private practice. She called 4 different practices but none were taking new patients.

A beloved, highly regarded physician in my area has left his practice because he feels he can’t spend the time he would like to spend in treating his patients and keep up with the paperwork that more insurance companies are demanding. Let’s face it, patients are living longer with more chronic illnesses than ever before. How do we deal with their problems in 10 to 15 minutes?

We’re losing primary care providers by the fistful for a number of reasons not least of which is the poor reimbursement rates for Medicare and Medicaid. Western Mass is considered rural so insurers are allowed to reimburse practices less money – even though they do the same job as their counterparts in the eastern part of the state. In addition, we are under increasing pressure from the insurance companies to track outcomes on chronic illnesses such as diabetes, depression, heart failure etc as well as keep track of preventative measures such as colonoscopies, PAPs, mammos etc.

Small practices simply don’t have the resources to do this and they get penalized for this by reduced reimbursements and lower ratings. Think of how many times your own health insurance has changed. Your new insurance company doesn’t have a record of, let’s say, the colonoscopy that you had done 2 years ago but it’s up to the individual provider to constantly update the insurance companies. It’s quite a tedious process to do this on literally hundreds of patients from just one insurance company. What is exquistely frustrating though is when the insurance companies don’t update the information you give them. The result is that more and more of your practice’s limited resources are spent on trying to appease insurance companies. And when a patient refuses to get a service done like a PAP or mammo or colonoscopy, the provider is held responsible.

It’s not that certain measures shouldn’t be tracked but by putting the burden on practices to supply this information when the resources simply aren’t there to do this leads to practitioner burn-out. Why not have insurance companies share this information? 

Massachusetts legislature is examining the problem of primary care provider shortages and is considering options such as decreasing the amount of paperwork, offering to pay for student loans, and increasing reimbursements for services done. Providers and patients are speaking out. You can hear more about this on this NPR report.