You can lead a doctor to government insurance, but you can’t make him treat you 

Despite the fact that Obamacare greatly expands Medicaid, we’ve known for while now that doctors are refusing to see patients when government dictates the price of the treatment. I discussed this problem in a column I wrote back in December:

The policy outcome is Econ 101: Price controls always result in scarcity. Over half of all specialists in many major metropolitan areas are refusing to take on new Medicaid patients, according to a 2009 survey by Merritt Hawkins and Associates on physician wait times.

“Medicaid is not widely accepted in most markets surveyed, in at least some of the medical specialties reviewed, and, in some cases, all of them,” according to the survey.

The practical consequences of the government printing more health care IOUs than doctors can handle are horrifying. The Baltimore Sun recently reported that state auditors found 250 people out of the 17,000 people listed on the state’s Medicaid waiting list are deceased. Other states have similarly outsized Medicaid backlogs of people desperate for medical care.

Now, according to USA Today, this problem is spreading. Doctors are quickly finding it unprofitable to treat Medicare patients as well:

• The American Academy of Family Physicians says 13% of respondents didn’t participate in Medicare last year, up from 8% in 2008 and 6% in 2004.

• The American Osteopathic Association says 15% of its members don’t participate in Medicare and 19% don’t accept new Medicare patients. If the cut is not reversed, it says, the numbers will double.

• The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.

The federal health insurance program for seniors paid doctors on average 78% of what private insurers paid in 2008.

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Mark Hemingway

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