Yep, the commiecrats in CA will soon sink it like Detroit. Come on to TX CA docs.
You really do not understand economics, do you?
If doctors in California do not accept medicare patients they can expect to see a large drop in the number of patients in their practice. As the patients get fewer and fewer the profits become less and less. The fact of the matter is that if people cannot afford the doctor they will not go to the doctor! The bottom line is this, those doctors who initially decide not to accept medicare will be forced to do one of three things.
1) To rebuild their practice they will have to lower their rates.
2) They will have to re-evaluate their positions on medicare.
3) The will have to leave their profession and seek work elsewhere. The problem is this, they have special training in medicine and little training in anything else. That means they will be pushed into the poor jobs market with few skills to sell.
Some of you will say how terrible this is and the doctor shortage will be a huge problem. Wrong. There is such a thing as a physicans assistant or PA. A PA can do many of the same simple tasks that a doctor does and they can gain those skills in two years. The PA's are under a doctor's watch but one doctor can have several PA's.
Let me give you an example. My wife has a failed back. Implanted in her abdomen is a small pump that delivers medicine directly to her spine. The pump needs to be filled about every 6 weeks. However, when she gets the pump filled she does not see the doctor. She sees a PA who fills the pump. If the PA sees anything out of order she reports it to the doctor and then he takes over. She hasn't see her pain doctor in 2+ years.
Let me give you an example. My doctor bailed as soon as obama won the election. He wasn't going to try to struggle through. His office is now staffed by a PA under the supervision of a floating doctor. I have some minor but chronic conditions that need to be monitored. Because the new structure of the medical practice demands electronic records, the PA gave me a complete medical evaluation. She diagnosed me as having arthritis, acid-reflux, diabetes, copd/emphysemia and heart disease. Except, I actually do not have ANY of those conditions. The PA said that these conditions were very common among people my age and if I didn't have them, it would be thought that she missed them. The prescription for dealing with these various conditions was to become a regular watcher of the Dr. Oz show and take a pinch of tumeric every day.
Because of my electronic medical records I now get telemarketers regularly calling me offering "free" diabetes testing supplies. When I tell them I don't actually have diabetes, they urge me to accept the testing supplies because they are free.
Doctors cannot afford to take patients that it costs more to treat than what they get on their reimbursement schedule. What doctors are really doing, rather than what people think they are doing, is going to all cash or concierge service. Entire hospitals are forming their own concierge networks. This has a benefit to maximize income by the simple act of not having someone process insurance claims. The people who prepared, submitted and followed up on insurance payments are just out of work. By going to all payment for services received, doctors make more money and don't need such a large number of patients to pay the rent! While my general doctor has turned out to be an incompetent PA, I pay my gynocologist in cash. Each visit is $50.00, including all lab fees. Because she has moved to payment for services, there is no waiting, I see a real doctor. Even doctors who see medicare patients limit the size of their medicare patients to no more than ten percent of their patient load.
I know several people who have moved to a concierge service. They pay once a year, for minor visits the doctor comes to their home. They pay nothing for individual doctor visits. It's all covered under the yearly payment. There are specialists in the concierge network also covered by the yearly payment. The hospital in the concierge network is Cedars Sinai. Cedars also sees medicare, obamacare and medicaid patients. You just don't get a doctor, you get a student or a PA or even a nursing assistant. Your room isn't as good.
As the patients become fewer and fewer, the doctors work less and actually make more money. The poor are relegated to clinics and county services where the "doctors" are mostly students who are supplemented by physician's assistants and nurses. You can get an advanced student or a newbie. You won't actually know this of course. They are all "doctor" to you.
As doctors bail on obamacare, there will be only two options. Either accept that the medical care available to those unable to pay is severely limited to none or prohibit medical licenses to doctors who refuse to be in the obamacare network. In that case, doctors will simply leave the US like so many other professionals have done.
