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A Massachusetts Physician Offers a View of Healthcare Reform

Mario Motta, MD, for HealthLeaders Media, August 13, 2009

Massachusetts enacted universal healthcare three years ago, and since then many have looked at us as a potential model for the nation. We've insured close to 98% of our population, adding nearly 450,000 to the insurance roles—an enviable achievement. But the strains are evident.

With physician shortages, especially in primary care, we've discovered that universal coverage does not mean universal access to care. Some patients are having difficulty finding a primary care doctor, and long wait times exist. And like others, we struggle mightily with the cost issue, exacerbated by a shrinking budget battered by a severe recession.

But the will to succeed exists, and we move ahead. A special panel on payment reform has recently recommended a new way to pay hospitals and physicians, with the goal of reducing costs.

Reforms at the state and federal levels aim to improve quality, reduce costs, and make healthcare more affordable. Physicians know that rising costs are unsustainable for the individual, the employer, and governments. We also know plenty of opportunity exists to improve the quality of care.

Physicians want to be—and should be—part of the process to build a better healthcare system. We are, after all, those who deliver the care. But this willingness is tempered with a certain degree of concern, born of experience. The last two decades have produced many big ideas to improve quality and affordability, launched with high hopes and great expectations. But most of these notions have failed, often making matters worse and driving a wedge between patients and their physicians.

Our hope for reform, at all levels, is that efforts, besides enhancing care and cutting costs, will restore dignity to the patient-doctor relationship.

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