Bart Hinkle asks what I think is a pretty good question:
If insurance companies can’t turn people away, then why should physicians be allowed to?
4.4% of physicians accept no new private patients. 14% accept no new Medicare patients. Almost 30% accept no new Medicaid patients.
40% of physicians provide no care free or at reduced rates, generally considered an ethical obligation.
The answer that physicians generally give to the question is that they must turn away some patients to be able to provide adequate care to the rest. That the patients turned away are those for whom they receive less compensation is just one of life’s mysteries.
I don’t think that the answer to the question resides in something as abstract as self-determination or speculative as the ability to provide adequate care. I think that it was easier to persuade insurance companies that they would benefit from a larger pool of subscribers than it was to persuade physicians that they should do more work for lower pay.