For Massachusetts Doctors, Two Sides to Reform

Massachusetts passed a comprehensive health care reform law in 2006 that proved to be a model for the national law passed this year. Tonight on the NewsHour, health correspondent Betty Ann Bowser looks at how reform is working out in Massachusetts, four years later. She talks to health policy experts, doctors, patients and hospital administrators in Franklin County, a rural county in the northwestern corner of the state, and finds that many more people have health insurance – but costs are still going up, and a shortage of primary care doctors means that emergency rooms are still crowded.

In this online extra, the NewsHour talks to two primary care physicians in Franklin County.

Joseph Viadero has practiced medicine for 25 years in Turners Falls, a town of about 5,000 people in Franklin County. His practice, Connecticut River Internists, was oversubscribed before reform, and is even more so now. The practice is now closed to new patients, but he says that he and his colleagues get more than 30 requests a week from patients who want to join — up from 5 to 10 a week before reform.

But overall, he says that health care reform has been good for his patients, providing new options to people who would have been uninsured before – such as young adults – and encouraging them to get primary care.

Sarah Kemble is a physician at the Community Health Center of Franklin County. She says that although health reform has expanded insurance coverage in the state, it has actually made it more difficult to provide care for some of her patients.

That’s because before health care reform, community health centers in Massachusetts were able to bill the state’s “uncompensated care fund” for any care they provided to patients who earned less that twice the poverty level, and so they could provide that care without co-payments or other charges. Now, however, almost everyone has health insurance, but some is less generous than others, and the center must work with patients to try to navigate the confusing thicket of insurance charges.

Tonight on the NewsHour, we’ll have more on health care reform in Massachusetts.