• Wait 5 more days to see the doctor or pay $25 more each month?

    As reported in the Boston Globe yesterday, the Massachusetts Medical Society just released the results of their annual survey in which they called physicians’ offices and asked when a new patient could see the doctor.  The average waits ranged from 24 days to see a pediatrician to 48 days to see an internist, and more than half of the adult primary care doctors refused to see new patients at all.  These results have received some national attention because Massachusetts passed health reform legislation in 2006 that is  the model for President Obama’s health reform law, scheduled to take effect nationally in 2014.  Following reform, as more Massachusetts residents obtained insurance coverage and the supply of physicians in Massachusetts stayed roughly constant, waiting times for appointments went up.

    Anticipating that the same sort of thing will happen across the country in the next few years, my colleague Julia Prentice and I just released a Working Paper (forthcoming in the Journal of Health Economics) that estimated how much people would be willing to pay in higher premiums to avoid longer waits to see the doctor.  The answer: about $25 a month in higher premiums to avoid waiting an average of 5 days longer for each visit. This doesn’t seem to me to be enough to fund a major expansion in physician supply, so it’s likely that we’re all going to be waiting a little longer to see the doctor in the near future.

    A few cautions are in order.  This research was done on a sample of Medicare eligible veterans who could choose between very inexpensive care at the VA with long waits and more expensive care from Medicare with shorter waits.  When VA waits increased, more veterans purchased Medigap insurance, signaling their intention to rely more heavily on Medicare (Medigap pays Medicare’s hefty copayments and deductibles).  Younger and healthier people might not have been willing to pay so much, and higher income people might have been willing to pay more.


    • According to other reports, wait times have not gotten any worse since the 2006 law – they’ve been bouncing around similar numbers for a long time.

    • Interesting. The MEDPAC report claims that wait times are more common for privately insured patients and that Medicare patients have better luck at finding a PCP. That would suggest, I think, that is is at least not payment levels accounting for this, if it is anything more than a statistical anomaly. Of note, wait times in our area to see most pediatric specialists are longer than noted in the study.



    • Variable pricing, sort of like airline tickets.

      What if you are sick? ER?

    • This is a supply side problem, they need to make it easier to become a doctor. My nephew who wants to be a doctor is panicked because he got one B as an undergrad. Also if Mass. it is like here in FL there are Doctors from other countries that cannot get a license to practice.

    • I agree with Floccina. As well, I have read about the heavy requirements for foreign doctors. Most medical boards are opposed to anything innovative.