They don't even have to go that far. All they have to do is make participation in Obamacare a requirement for licensure.
There is a good chance the mandates will be found unconstitutional and I doubt that zero could force physicians to accept Medicare, Medicaid and 0bamacare exchanges with the threat of a loss of licensure. Here is why:
1. They seek to cover 30 million more people beginning in 2014, but there is no provision to hire, import or train new doctors or providers. We also have an aging population that requires more treatment.
2. The medical homes will actually restrict access to specialists by providing primary care physicians and providers financial incentives to withhold referrals and advanced testing. As the article indicates, 65% of physicians are specialists. The specialists provide the bulk of advanced cardiac, cancer, musculo-skeletal care. The specialists do the heavy lifting and are directly responsible for improved disease outcomes. With reimbursement cuts to specialists, the demand for specialty care will be intense and efforts to prevent those specialists from opting out of some of the government programs via coercion will simply backfire big time.
3. It takes 4 years of med school, and another 4 years residency (in most cases) to practice medicine after college. Specialists take 6-7 years or longer AFTER Med School for cardiology, neurosurgery, orthopedics training. Even if a surge of college seniors went into Med School right away, you would have to wait at least 8 years for a primary care doc. But even more, there is not enough capacity at medical schools to accommodate any immediate surge of medical students.
4. Despite the poor economy, the interest in being a physician is waning. The August 09 IBD poll showed that 46% of current doctors are considering quitting or retiring early. Many children of doctors become doctors and many physicians are advising their kids to stay out of medicine.
5. Don’t count on nurses to get advanced practice degrees to pick up the slack. The median age of an RN is really starting to get up there and giving nurses some of the responsibilities of physicians will exacerbate the existing nursing shortage.
Beggars can’t be choosy. With 0bamacare, the government will be the beggar. Punishment will only accelerate the fight out physicians out of medicine.