You mean Romneycare?

I'm a lifetime MA resident, and this is reason enough for me to never vote for Mitt Romney.

Romney did not swoop down from the heavens and inflict this on Mass. Romney is no longer Governor of Mass.

If it's not working, repeal it or fix it.

You mean Romneycare?

Yes. But Obamacare is pretty much the same. So one may expect similar results.

>>"41 days to see an OB/GYN, up from 34 last year."

Damn. My OB/GYN can usually take me in about a week for a routine exam, and when I wanted a pregnancy test, they booked me for two days later.

Granted, getting in to see my GP has always been more difficult (probably a month for just a checkup).

Romneycare is an example of Obamacare. I should have made that clearer in the post, but I try to not post too much of an article and this one was short.

OK, so there are less doctors accepting patients. But I need more information on WHY. Is it because they have a full boat of people they can reasonably serve, or do they just not want more patients for some reason?

OK, there is a longer wait for an appointment, and that may be connected to an increase of emergency room visits. But is that because there are less doctors, or more patients? Are doctors leaving the state or retiring because of these practices?

The article suggests both are a result of more patients. Well, I admit that more customers makes it hard to get served, but I'm not sure more people being able to get to doctors is a bad thing.

It doesn't say anything on if quality of care has dropped. It does say that their premiums are high, and that's no good, but I just don't see enough in this article that screams "FAIL" yet.

If Doctors can still make money, people will still want to become doctors, and if demand increases, prices should rise, which will attract more to become doctors, and reduce the demand issue, albeit, quite a few years down the pike. If the system makes it impossible for a doctor to be profitable, less will want to, and the problem will increase.

At least Romneycare is indeed a universal system, so it can be studied to see how a larger system might work. But right now, there are so many exclusions and exceptions to Obamacare that it's NOT a universal system, and will likely not behave in line with the former, it'll work less well.

There were so anxious to pass SOMETHING, they pared it down to a nub that even the people who were going to vote for it didn't want to have to follow, so like what, 19 states are excluded from participating?

But I need more information on WHY. Is it because they have a full boat of people they can reasonably serve, or do they just not want more patients for some reason?

My guess is that, now that everyone in MA has to get health insurance, they figure they might as well use it. If you're uninsured and have to pay $600 for an office visit with the gyno, and you don't have insurance, you're more likely to skip, leaving that "spot" open in a doctor's schedule. But, if everyone has insurance, they are more likely to get preventative care with a primary care physician.

Being a primary care physician has long hours and lower pay than specialties -- and a lot of young doctors are saying "No thanks." This could be a reason for the shortage in PCPs.

It's an interesting problem. The system in the U.S., as it is, is terribly broken and disgustingly unfair and needs fixing. And yet health care reform creates a slew of new problems and complexities:

Everyone gets insurance (yay!), but not necessarily everyone will get -- and be able to afford -- care (boo!). The reform law addresses efficiency in preventative care and cost-reducing measures (yay!), but these measures will place immense pressures on doctors and punish them if their patients decide to be unhealthy (boo!).

"Yes. But Obamacare is pretty much the same. So one may expect similar results"

Expect worse.

Mittens will be unelectable because of this albatross (or he should be at any rate). This morning I heard some radio fluff station saying Mittens wasn't electable because he was Mormon. Horse shit.

Here's the thing about a "universal" health care system - there are too many exposures and factors for it to be profitable on such a wide scale. And with the government involved, that makes things even worse.

What works are tightly controlled subgroups that are underwritten according to participants (lifestyle, product choices, limits, deductibles, etc). Or, insurance. What works is competition and free market principles. What works is many options that fit an individuals needs and lifestyle. What works is personal responsibility and a mandate requiring the insured to PURCHASE A POLICY PRIOR TO A LOSS. This is common sense.

Now, if we are having a problem with it being profitable for one small state, how on earth could we possibly think this can be applied with any success to all states, or a greater area of exposure? Hubris maximus!

Look at Canada. Look at England. EPIC. FAIL.

Another thing to mention here is that there are insurance carriers that are backing out of writing healthcare coverage in Massachusetts on account of this system because it is not profitable - which only compounds the problem.

Disaster. Everyone talks about Mittens being such a great businessman. His decision here would reflect otherwise.

"If Doctors can still make money," VinnieB...

well, there's your problem. What make you believe that you can make money? Government Insurance means Price Control, which means they tell you what something is worth, regardless of what it cost you to do.

If you have 50 new patients that you have to take, and their basic care is reimbursed at a price less than your cost... are you going to accept them?

You think it might have something to do with a nationwide shortage of PCPs? Perhaps we should do more to address the fact that we graduate too many specialists and not enough PCPs. It's easy to see why, look at the income by medical specialty, pediatricians, family practice and other PCPs are at the bottom, while surgical, anesthesiology and radiology specialties make much more. It's the market that drives this, people go where the money is particularly when most graduate with $100s in debt.

Funny thing about American health care. Its the most expensive per capita in the world, yet we are less healthy for it when compared to other advanced nations. We get screwed in terms of bang for the buck. Other nations have managed to solve the dilemma of how to provide better access at lower cost with better outcomes. We could learn from them if some of us could set asides prejudices. The market can work, if both sides of any purchase have equal knowledge of the product or service and can compare all available options. These thing are more often than not simply not true when it comes to the purchase of medical services.

BTW since Romneycare came first by several years, isn't it more accurate to say that ACA is a form of Romneycare? I would also note that Congress wrote the ACA, not Obama, so I wont call it Obamacare. To be sure, it has glaring defects, mostly because it preserves the ridiculous employer-based system and the parasitic role of insurance companies. In my experience insurance companies add nothing but administrative overhead and annoyance. They aren't the fix for the system, they're a large part of the problem.

"Funny thing about American health care. Its the most expensive per capita in the world, yet we are less healthy for it when compared to other advanced nations. We get screwed in terms of bang for the buck."

What the... We can also get MRI's and EKG's and emergency surgery within hours if our primary care physician so directs it. We have access to top shelf medical equipment and specialists. What about Canada and NHS? People DIE waiting to get brain tumors removed because they've been wait-listed for months. People in Canada resort to veterinary medicine because they are wait listed...for months sometimes years.

It's no wonder that Canadians are using health care brokers to access healthcare in THIS country to manage life saving services not offered at all - or not offered in a timely manner. And you say this works?

Here is one story (article) from a Canadian, who actually lived the universal heath care system first hand:

http://www.city-journal.org/html/17_3_canadian_healthcare.html

"In a subzero Winnipeg morning in 1997, I cut across the hospital emergency room to shave a few minutes off my frigid commute. Swinging open the door, I stepped into a nightmare: the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine. Right then, I began to reconsider everything that I thought I knew about Canadian health care. I soon discovered that the problems went well beyond overcrowded ERs. Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation whom we referred to a pain clinic—with a three-year wait list; or the woman needing a sleep study to diagnose what seemed like sleep apnea, who faced a two-year delay; or the woman with breast cancer who needed to wait four months for radiation therapy, when the standard of care was four weeks."

"Funny thing about American health care. Its the most expensive per capita in the world, yet we are less healthy for it when compared to other advanced nations."

I challenge that statement on its face. To give an example, we've recently seen how European nations jigger their infant-mortality statistics. You can make your health-care system look really good by only treating the healthiest patients.

If we let the Pep Boys constrict the supply of mechanics, we'd have chevys piled up at the door like bodies in the ER as well.

We need to increase the supply of GPs?

No problemo.

The expense statement is accurate. Infant mortality is a flawed comparison, though not because other countries "jigger" their stats, it's just a different categorization for live births. However, within the US where comparisons are accurate, there are really awful disparities in infant mortality based on socioeconomic status and race that I find more disturbing than the cross-national ones.

My source for expense comparisons, you can judge it for yourself -http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx

Sorry but when some nations dont count "live" births until after a month has passed that is messing with stats to make your stats look better.

Comparing nations stats against one amother is a pointless endevor until the varibles used to collect such stats are stanndardized

Which is why I said disparities within the US are more disturbing to me.

Where did you find information on how other countries report live births? What I have read is that here we are moving earlier and earlier in classifying pre-term births as "live" whereas other countries don't do that. As in, we classify a baby born so early it's going to die as a live birth, then it counts against our infant mortality rates, and in Finland or wherever that baby would never have counted as a live birth. I guess I can see that as messing with stats but I can also see it just as a different approach and philosophy of care....