If the Massachusetts effort to attain universal health coverage is any indication, then national health reform will certainly face roadblocks. Presenting at the 2011 RSNA conference, Alexander Norbash, M.D., highlighted some of the unexpected outcomes and barriers faced in his home state, which passed a health reform law in 2006 under Gov. Mitt Romney.

Norbash, a radiologist at the University of Boston Medical Center, noted how the state faced some similar problems in 2004 that the nation does now, most notably rising health care premiums. Under "RomneyCare" the state mandated insurance coverage, and today nearly 98 percent of residents have health insurance. But due to a severe shortage of primary care and internal medicine physicians, the wait times for appointments have worsened, Norbash said. Wait times to see a general internist are typically 48 days, which is "not acceptable," he said, noting that the long wait continues to drive patients to emergency departments, where the cost of care is higher. Overall, care costs in the state have continued to rise.

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