Consumers Fear Universal Coverage Could Cause Healthcare Access Bottleneck

States with high uninsured populations generally have lower ED use than states with lower uninsured populations, the study found. Massachusetts, where only 3% of residents are uninsured, has one of the nation's highest per-capita ED utilization rates. The Bay State also has the highest number of physicians per capita, but has been plagued by a severe physician shortage since introducing near-universal coverage in 2006.

The survey accompanying the study was conducted in April and found that people are willing to try alternative ways to access care, including:

• Electronic interaction with providers and payers: 50% of respondents say they'd be willing to seek healthcare through the Internet or other computer technology as a substitute for a face-to-face, non-emergent visit. E-mail consultations were the preferred method of interaction (76%), followed by telehealth, question/answer fee-based consults, and an online forum/chat room monitored by a doctor. Nearly three-quarters of consumers say they would use biometric electronic remote monitoring services to track their condition and vital signs.


• Retail and worksite clinics for patients: 37% of respondents say they'd be likely to use a worksite clinic, and 36% would use a retail clinic. Ten percent of large employers surveyed in PwC's 2009 Annual Employer Barometer Survey say they're providing worksite clinics, up from 1% in 2008.


• Shared medical appointments: 28% of respondents say they'd support the concept, which typically involves a 60- to 90-minute session that includes a private or personal exam integrated with patient education and discussion with a group of 10 to 15 people.