Color me unsurprised.

A Boston Globe article today confirmed what has been discussed on this blog during the past year. Universal care without primary care access is a recipe to increase both emergency department crowding and health care spending.

We now have more data to back up this expected conclusion.

Despite an individual mandate covering almost everyone in Massachusetts, the cost of emergency care has risen 17 percent over the past two years, while ER visits rose 7 percent.

Stating the obvious, officials have concluded that, “emergency room crowding and rising costs will not be solved by providing people with health insurance alone,” and, what is needed “are more primary care doctors and nurses.”

It is very likely that whatever plan President Obama and Congress hammer out will look very similar to the Massachusetts approach, and I fully expect that the federal plan also will include an individual mandate, forcing everyone to purchase insurance.

And again, the results are going to be predictable. Without adequate primary care access, these newly insured patients will flood already crowded emergency rooms for care, further driving up spending and costs.

If you think what’s happening in Massachusetts, which by the way, has the highest density of physicians per capita in the country, is scary, replicating this scenario nationwide will be truly frightening.