Can universal health coverage be sustained long-term?

With health reform looking more likely, it’s worth looking at the Massachusetts model to predict what’s going to happen nationwide.

I’ve written several times that the lack of primary care access will simply shift newly insured patients to already crowded emergency departments, where care is exponentially more expensive. And in the end, it is that lack of spending control that will make the costs of universal coverage unsustainable.

According to recent data, well, we’re pretty much on that path.

In an article from American Medical News, a poll of Massachusetts emergency physicians stated that, “42% of the 138 physicians surveyed said emergency care had ‘somewhat increased’ since the reforms took effect, and 22% said such care had ‘significantly increased.'”

Furthermore, many of those who seek emergency care already have insurance, disproving the myth that the uninsured are primarily responsible for filling up ERs.

There’s little question that providing universal coverage is a laudable goal, but it cannot be done without consequence. With little relief for ER crowding being discussed, a scenario where the majority of Americans have coverage, but cannot access care, is going to be likely possibility.

And that’s going to threaten the long-term prospects of providing everyone with access to affordable health insurance.

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