Obama to push public health plan, forced physician participation

The New York Times is covering the opposition to a public health plan (government pre-paid health care) by the American Medical Association.

Within that article is the news that the Democrat leadership intends to not only implement a government insurance plan that would compete with private insurance companies, but the legislation would force doctors who already accept Medicare to accept this new plan, also.

America’s Health Insurance Plans, a lobby for insurers, said Tuesday that the government plan proposed by some Senate Democrats could “dismantle employer-based coverage and significantly increase costs for those who remain in private coverage.”

Under a proposal favored by many Democrats, doctors who take Medicare patients would also have to participate in the new public plan. Democrats say that requirement is needed to make sure the public plan can go into business right away with a large network of doctors.

The medical association said it “cannot support any plan design that mandates physician participation.” For one thing, it said, “many physicians and providers may not have the capability to accept the influx of new patients that could result from such a mandate.”

“In addition,” the A.M.A. said, “federal programs traditionally have never required physician or other provider participation, but rather such participation has been on a voluntary basis.”

Those who had Medicare supplements that paid for their drugs before the Medicare Part D plan was implemented will remember their surprise when they were forced out of their old plan and onto the new one. The big surprise came when they hit the "donut hole," or the level when they had to pay for all of their own prescriptions.

Imagine your boss has the choice between buying insurance, or (as in Massachusetts) paying a fine that is less and allowing you to be absorbed by the government plan.

Now, imagine that you can't find a doctor that is taking new patients. Or a doctor that can see those patients within a reasonable time frame.

Here in Texas, some Medicaid patients are assigned to clinics, not doctors. Their "primary care providers" are not doctors, but groups that hire nurse practitioners to see them, to take call, and to manage their care.

In fact, Rural Health Clinics are required by Federal law to hire Physician Assistants or Nurse Practitioners who *must* do a certain percentage of the visits and patient care - I believe it's 50%. In other words, the government forbids the doctor who owns the clinic from seeing all his own patients and keeping the patient load at a reasonable level. Just another example of unintended consequences of government interference.