Health Care Reform in Massachusetts PART II

Today's issue of the NEJM has a "Perspective" piece entitled "Health Care Reform in Massachusetts — Expanding Coverage, Escalating Costs" (click the title for the link to the piece).

It is very similar to the NY TImes editorial we posted last week. It seems very upbeat about the added coverage but also points out:

Not all the news is good, however. Perhaps 5% of the state's population — the exact figure is a matter of conjecture and may be higher — is still uninsured, the financial burden of the reforms is increasing, and the challenges of sustaining the subsidized program have been exacerbated by the economic downturn. The features of plans that decrease the cost of premiums also increase out-of-pocket costs for those who obtain care. Although adults reported lower levels of health care needs that remained unmet because of cost in the fall of 2007 than in the previous year, those with low ncomes reported increased difficulty in getting appointments or in finding a doctor or other provider who would see them.

It also says, and I think this is the most important point:

Health care reform in Massachusetts is not a panacea for the many shortcomings of the health care system. It is worth remembering that California, for example, has more people without health insurance (6.7 million) than Massachusetts has residents (6.4 million) and that the financing and delivery of medical care have not changed. Having health insurance is not having health care.

This brings up what is almost always missed when evaluating these healthcare reform plans; does it improve the health of the population? All we know now is that it costs more (even more than projected) and that more people are covered, but what is the benefit?

Gil