I’ve said it here time and time again. We’re a hair breadth’s away from the Feds dictating that doctors accept Medicare/Medicaid patients; no choice.
It’s coming. Mark my words.
I don't doubt it. The official position of the goobermint is, "If you need a license from us, then your practice is a privilege--not a right-- and we don't care what degree you have." This means, the goobermint can force you to see medicare/ medicaid patients anytime they want--at a price of their choosing-- and if you refuse, there goes your license.
Licenses so far are issued by States, but that can be over-ridden by the fascist Usurper's whores in Congress introducing the necessary legislation, assuming it is not already in the obamacare bill, somewhere in the back 500 pages of fine print.
They may try to mandate that we see medicare and medicaid patients, but they can’t keep me from retiring early and walking away. Many of my colleagues have plans to do so if Obamacare is not repealed or defunded. An imperative to treat medicare and medicaid patients will just make it happen that much faster. This country is going to lose a tremendous amount of medical talent in the next few years, as many of us just walk away.
What the government will try to do (as is being proposed in MA) is to require participation in government insurance programs as a requirement of medical licensure. There is even talk of requiring providers to limit charges to the Medicare or Medicaid rate. Of course, this would create a great deal of consternation among physicians and providers and destabilize the health care system considerably. No doubt, many doctors would drop out but many more would be forced to join hospital groups as a means of subsistence. At least in the short term, hospitals and large health care organizations will be shielded from drastic cuts to absorb essential but margin losing providers. This fits the Leftists model because, providers will now be an employed and captive group ripe for unionization and administrative control. This allows the statist to more firmly and directly ratchet down costs and restrict/ration care.
However, this heavy handed approach, although so desired by the Leftists, is too oppressive IMHO to succeed. Forcing doctors to accept patients below cost will be difficult to micromanage and enforce. Providers will resort to all sorts of strategies to avoid treating these patients. Ultra-short visits, group visits, quick referrals, and inordinate patient paperwork requirements will stall low margin patients. Government patients could be labelled as “difficult” and discharged if they become cross with the staff after waiting 3 hours. While discussing treatment, the doctor could emphasize all of the potential complications and difficulties thereby frightening the patient away. Legal challenges to forced labor on government insured patients will invoke charges of involuntary servitude and will likely be supported at least at the red-state level. Meanwhile, physicians will continue to see well insured and cash patients through direct payment or through other means such as retainers, boutique models, or some type of independent contractor arrangement with the patient, group or company.
I don’t really think it will come to any of this in the end and the pendulum will swing back to liberty and economic freedom soon. Keep your faith in the goodness of liberty.
“It’s coming. Mark my words.”
As a doc, I’m sure you’re right. I would never encourage my child to go into medicine, even though it has been a profession that I’ve loved and have given much of my life to. It’s not about the money. It’s about self-determination. How can I truly feel I live in a free country when I can’t even decide what is fair payment for my efforts and services, and the government can make me do work for compensation rates below what it costs to render those services?
Not to worry. I’m sure everyone can find some really good attorneys, or ‘public servants’ to treat their illnesses. Heck, there are so many ‘experts’ and self-anointed geniuses in politics that there should be no problem getting one of them to make a proper diagnosis and treatment plan for whatever ails you.
“...We’re a hair breadth’s away from the Feds dictating that doctors accept Medicare/Medicaid patients;...
Totally agree with you.