President Obama has a single-payer government health care system as one of his highest priorities in his administration. And with the burgeoning number of Americans without health insurance, the Obama administration will have the political cover to get universal health care enacted in America.
But there is a complication in the system that won’t go away.
In today’s world, a doctor can still refuse to accept insurance payments, and require patients to pay cash.
Thousands of doctors have dropped out of big medical insurance provider networks, like Aetna, Cigna, Blue Cross/Blue Shield and United Health. Most common among doctor complaints are diminished reimbursements and the growing delay in payments.
Doctors have seen their real incomes plummet due to the stranglehold that the HMOs, government programs, and big provider networks have on their practices. I know many physicians who have one or more employees whose job is solely dedicated to fighting with the insurance providers over coverage and payment. Doctors are finding that it’s not worth the money they have to spend to file the paperwork to get paid a substantially reduced fee for services rendered.
Doctors are also refusing to accept Medicare and Medicaid patients because of the same diminished reimbursements and the growing delay in payments. A 2005 Community Tracking Physician survey found that only 50% of physicians accept Medicaid.
The Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare patients looking for a primary care physician had trouble finding one, up from 24% the year before. A 2008 survey by the Texas Medical Association, for example, found that only 38% of primary-care doctors in Texas took new Medicare patients. The statistics are similar in New York.
HMOs are problematic as well. Recent surveys from New York show a 10% yearly doctor dropout rate from the state’s largest HMO, the Health Insurance Plan of New York, and a 14% dropout rate from Health Net of New York, another big HMO. Those statistics are common across America.
None of the present-day insurance networks or government programs offer patients the care they need. Combine that with care that is ever more expensive and requires pre-qualification for most procedures that can degenerate into a fight between patient, insurer and doctor.
Naturally, Obama’s people say that in a single payer system, these problems won’t exist. But, in my opinion, they will only get worse. As more and more doctors opt out of participation, there will be fewer and fewer who remain in the system. Demand will skyrocket, as the supply of doctors in the government system shrinks. When demand outstrips supply, you can usually expect prices to rise. But Washington will place price controls on medical care. So expect long waits for medical procedures. You might die before your medical condition can get treatment.
The next question about universal health care’s dropout rate is obvious: Will the Federal Government require all doctors practicing medicine to accept patients with insurance coverage? When that happens, you will witness the largest flight from medicine ever seen, as doctors retire or change careers to escape government control of their lives. More doctors leave the profession, fewer doctors enter the profession, and the prescription is disaster.
The final question expands upon the last one: Would Washington make it illegal for a patient to seek medical treatment outside of the universal health care system?
Think about it, folks. It’s Washington. It’s the Federal government. With the naked power grabs we’ve witnessed in the last ten years, nothing is impossible.
I hope I am never a patient with a medical problem under universal health care.