Marc Seigel misses something big (h/t Instapundit). Let's see if you can find it...
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...
...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. I continue to send my elderly women patients downstairs for the test because she is so good, but no one is happy about paying.
Right now Seigel is correct, a physician could limit access to Medicare or Medicaid patients, as there's probably enough private payer business to keep them going. In fact, our old group closed to Medicare patients for a extended period for exactly the reasons above. But the pool of potential patients would shrink rapidly once the government takes over. In a universal care system, how would we opt out of a government monopoly short of quitting medicine?
A universal care system paid for by taxes would undermine the private insurance industry, much like the public school system limits private schools. Unless you have a lot of money, things would have to get pretty bad before people will opt out of something they've already paid for.
Q: Wouldn't the government provide private vouchers for taxpayers who might be unhappy with their care? That might expand the market for doctors who want to work outside the system...
A: snicker..snicker....chortle...cough.cough..COUGH...ahem. Excuse me.
Q: Sure the government controls licensing, and now a big market share of health care dollars. You don't think they would parlay that to passing EMTALA like rules to force doctors to care for all under a government health plan, would you?
A: cough..cough..COUGH..COUGH..wheeze..gasp........thump
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