Conservative Boot Camp

An opinion piece in The Wall Street Journal the other day was very interesting.  It’s written by a physician from New York, Dr. Marc Siegel.  The short version of the article is that increasing numbers of physicians are rejecting insurance coverages from the government because of the low pay they provide to the physicians for their services and also because of the labyrinthine billing and appeal procedures that come with government insurances.  Back in the day when I was a principal with a Medicaid HMO back in Michigan, I knew firsthand of the the number of physicians who chose not to have anything to do with us or Medicaid.  Well, that was ten years ago, and things have only gotten worse.  The numbers of physicians rejecting Medicare and Medicaid as payment sources are growing rapidly.  Many doctors are simply telling their patients, “I’m only accepting private pay arrangements after X date.”  In a free market, it’s hard to blame them.  They’re the ones who’ve taken the time and spent the money to become educated and licensed.  They’re the ones who’ve invested in the equipment and supplies needed to provide treatment to their patients.  They’re the ones who daily face the risks of practicing medicine in a litigious society.  And, no doubt, a lot of them are just tired of playing what they see as a game that they can’t win with the insurance carriers, especially the government ones.

Trust me, that trend toward rejection will fit neatly into the rationale of the government bureaucrats use as part of their justification for shoving a single-payer health care system down our throats.  They’ll tell the physicians that they’ll take the single-payer plan, or they won’t be allowed to practice medicine.  They’ll outlaw any competing insurance plans and they’ll outlaw private pay arrangements.  It’s inevitable that we’ll lose physicians from this move.  It’s also obvious that we’ll also see a decrease in the number of foreign-born physicians who want to move here.   Given that our insistence on insuring everyone is going cause an immediate shortage of providers somewhere in the neighbourhood of 210,000, this will have an instant and deleterious impact on the care all of us receive.