The growing numbers of politicians and special interest and consumer groups pushing health insurance for all often neglect-and sometimes penalize-the people they need most for such plans to succeed: America’s physicians. Politicians usually promise budget neutrality in proposing health insurance for the uninsured, but they raise funds the old-fashioned way-by raising taxes. And politicians choose their poison carefully. When they realize that raising property or sales taxes to cover the uninsured will raise the probability of their defeat in the next election, they look for easier ways to raise revenues, and wealthy doctors are a perfect target.
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February 2008Building universal coverage schemes on the backs of physicians, though, has backfired in several states, including Maine, Massachusetts, Michigan, Kentucky, New Mexico, and West Virginia. Elected officials should be learning that physicians just say no to plans that offer such negative financial impact as to be self-destructive to physicians who participate.
Massachusetts’ compulsory coverage-for-all plan is a case in point of politicians’ failures to understand the critical role that physicians play in subsidized health insurance plans. There have been widespread media reports of Massachusetts’ working poor and middle class, some of the 550,000 persons eligible for subsidized insurance policies, who have purchased policies, only to find that no primary care physician or specialist will take them on. The Bay State policy wonks neglected to grasp the Massachusetts Medical Society’s 2007 poll reporting that 49% of internists aren’t accepting new patients, and that 95% of generalists at Boston’s top teaching hospitals had stopped enrolling new patients.