Just a little anecdote about the likely future of Obamacare:

I was speaking with a doctor friend earlier today, and the topic turned to Medicaid, Medicare and private insurance reimbursement rates. He told me that Medicare pays him about half what private insurance pays, and Medicaid pays even less.

He takes Medicaid patients, but does so only out of a sense of community service. The reimbursement rates on their own make no sense.

Now the anecdote. In the small city in which he lives, the OBGYN’s only book Medicaid patients on Wednesdays, and they triple book compared to how they book other days of the week.

The reason for triple-booking on Wednesdays? Two-thirds of the Medicaid patients don’t show up for their appointments.

Why should they? They don’t pay for coverage or for missed appointments. When something is totally free there is no downside to treating it casually.

Now that there will be 15 million more people on Medicaid, the situation will get worse. The question is whether doctors will continue to take Medicaid, and if not, what will be the reaction of the administration.

Just as I predict coercion as to private pay medical care, so too there will be coercion as to physicians who refuse to accept Medicaid. Can anyone say “single payer”?

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