Why universal health care isn’t universal

A spot of cold water for those who seem to think that a simple wave of the wand (or, in this case, Presidential pen) can kiss the boo-boo and make it all better…

Here’s something that has gotten lost in the drive to institute universal health insurance: Health insurance doesn’t automatically lead to health care. And with more and more doctors dropping out of one insurance plan or another, especially government plans, there is no guarantee that you will be able to see a physician no matter what coverage you have.

Consider that the Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24% the year before. The reasons are clear: 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 state…

Doctors, it would seem, are just as economically motivated as any other individual and, when presented a choice of which insurers to work with, prefer those that neither stiff them on their fee nor pinch the pennies until Lincoln begs for mercy…

More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. I’ve had several new Medicare patients come to my office in the last few months with multiple diseases and long lists of medications simply because their longtime provider — who they liked — abruptly stopped taking Medicare. One of the top mammographers in New York City works in my office building, but she no longer accepts Medicare and charges patients more than $300 cash for each procedure.

How about Medicaid?  Any better over on that side of the fence?  HMO plans? Buehler?  Buehler?

The problem is even worse with Medicaid. A 2005 Community Tracking Physician survey showed that only 50% of physicians accept this insurance. I am now one of the ones who doesn’t take it. I realized a few years ago that it wasn’t worth the money to file the paperwork for the $25 or less that I received for an office visit. HMOs are problematic as well. Recent surveys from New York show a 10% yearly dropout rate from the state’s largest HMO, the Health Insurance Plan of New York (HIP), and a 14% drop-out rate from Health Net of New York, another big HMO.

Oops… guess not.

Now, who out there wants to be a patient when the government takes over the whole show?  Universal insurance through the government will place all the power in the hands of one insurer, allowing them to squeeze the medical profession at will.  Given the model of Medicare and Medicaid, government insurance will lead to reimbursement being squeezed to the point where doctors will leave the profession and university students won’t enter.

Government controlled healthcare — the efficiency of the post office and the bedside manner of the IRS.

3 replies
  1. Dimsdale
    Dimsdale says:

    The only problem: Obama will mandate that the doctors provide the coverage, which will either guarantee lousy coverage, or a lot of docs going John Galt.  Maybe they will just become vets.

    Unless the Obamadog starts issuing edicts too….

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