UPDATED: NE Journal of Medicine: RomneyCare: 18% increase in Administrators--No Significant Increase in Doctors/Nurses

UPDATE: Another problem discovered. To help pay for RomneyCare, reimbursements to doctors for Medicaid patients were cut.

Because of its own rising costs, the state government has cut payments to doctors and hospitals. According to family physician Dr. Katherine Atkinson, the state insurance reimbursements often do not cover her expenses: “Every time I have a Medicaid patient it’s like handing them a $20 bill when they leave.”

This has caused physicians to:

This week’s issue (June 16, 1011) of the

New England Journal of Medicine contains (updated) study which found that two-thirds of callers posing as mothers of children on Medicaid and/or S-CHIP were denied an appointment with a specialist for an urgent medical problem. Only 11% of those posing as having private insurance were denied an appointment.

UPDATE 2: Let me also add, Romney’s bad decision making continues…Romney has proposed allowing Health Savings Accounts to pay for traditional health insurance. This is the opposite of what the health care market needs. We need more people watching their bills, shopping around, and less time spent by doctors filling out insurance paperwork.


The Health Care reforms instituted by Governor Romney increased administrators by 18.4% compared to 8% for country but non-administrative positions grew at same rate as states without health reform. according to a report in the New England Journal of Medicine

From 2005–2006 to 2008–2009, employment per capita in administrative occupations grew by 18.4% in Massachusetts, as compared with 8.0% in the rest of the country (P=0.015). These administrative occupations include management, business and financial operations, and office and administrative support (including medical records and health information technicians). In contrast, employment levels in nonadministrative positions in Massachusetts increased by 9.3% after health care reform, an increase similar to that of 8.6% in the rest of the United States (P=0.796).

These data suggest that enactment of reform in Massachusetts was associated with more rapid growth in health care employment, primarily in administrative occupations and (perhaps) patient care support occupations rather than among physicians and nurses

Obviously, government health care requires lots of paperwork:

More important, our analysis supports physicians’ concerns about the administrative burden of health care reforms, an issue that will have to be addressed as the ACA is implemented.

So what happens when you add 400,000 people to health roles but not any more doctors/nurses as the rest of the country? It is no wonder that according to the Cato Institute:

As goes choice, so goes quality. Statistics on waiting times for specialist care in Massachusetts read like a dispatch from Canada. (emphasis mine) In 2004, Boston already had the longest waits among metropolitan areas. By 2009, waits had generally shortened in other metro areas (outside of Mass.) (average wait: less than three weeks) but lengthened in Boston (average wait: seven weeks), according to the Merritt Hawkins survey.

Really seven weeks!!! OK. So wait times increased but surely the quality is the same?

Voters who believe the Massachusetts law reduced the quality of care outnumber those who believe it helped by nearly 3-to-1 (29 percent to 10 percent).

OK. So more administrators, lower quality, and long wait times but at least it made health care more affordable and reduced costs?

“Premiums are growing 21 to 46 percent faster than the national average, in part because Massachusetts’ individual mandate has effectively outlawed affordable health plans.

OK. So longer waits, more administrators, lower quality, and reduced affordability of private insurance. But surely the government by being a bulk purchaser of health care can purchase at lower costs?

Since Massachusetts has covered just 432,000 previously uninsured residents, the cost of covering a previously uninsured family of four — at least $20,000 — is well above the average cost of an employer-sponsored family policy (about $13,000)

OK. So longer waits, more administrators, lower quality, reduced affordability, and greater cost; but according to Romney the people of Massachusetts know the costs and US taxpayers are not helping to pay for Romney’s experiment?

Had state officials not done their level best to hide those costs — the individual mandate pushed 60 percent of the cost off-budget, while expanding eligibility for Medicaid pushed another 20 percent onto the federal budget — no one would be hailing Massachusetts as a model.

OK. So longer waits, more administrators, lower quality, reduced affordability, greater cost, hidden costs to taxpayers in Mass and US taxpayers; but at least this will keep Massachucetts from going down the path to European single payer system that rations care?

To cope with the cost of its reforms, Massachusetts created a legislative commission that has recommended moving the entire market to a single, Canadian-style payment system that would encourage doctors and hospitals to ration care.

The mainstream media do not seem to understand why so many conservatives do not want Romney. My reason is simple: I want my parents, my kids, and my fellow Americans to have the best health care possible. Liberals and some Republicans like Romney have argued that we will not end up with the long lines and bureaucracy of europe with health reform. I hope this post helps people understand why I do not support Romney.