If a healthcare plan promises "you can keep your doctor", it's pointless

[Recursion]

This has been bothering me more and more. If a healthcare plan doesn't break the exclusivity of access that people with private insurance have on most providers then there's not any point to it.

Currently 1 in 5 physicians in the US do not take Medicare. A further 1 in 5 take Medicare but charge an additional fee to patients. 1 in 3 physicians in the US do not take Medicaid (last I checked if you take Medicaid you can't excess bill; I think that's still true).

Currently 25% of Americans avoid needed medical treatment because of cost. If health care becomes free to the patient, we're going to need to increase the amount of medical care we're doing by roughly one third. Unless we import or clone a bunch of doctors, that means every doctor is going to have to do more work, for less money (we pay twice the OECD average for health care and our doctors make twice the OECD average; this isn't a coincidence). There's probably a technological fix for some of this, and there's probably a regulatory fix for some of this (NPs and RNs could do a lot of what currently only doctors are legally allowed to do, for instance), but the fact remains we're trying to find a way to spend less total money to get more total medical care, and that's going to drastically change both where doctors are located and whom they see.

This bit us in the butt in 2010: "if you like your plan you can keep it". That wasn't true and we knew it: the whole point was that a lot of crap insurance plans had to go away. This is similar. There just aren't enough providers in the country to provide the level of medical service that people with private insurance currently get, and if we run from this problem it's going to bite us in the butt again.

[PoindexterOglethorpe]

1. Some years back my husband's health care plan changed

and all of a sudden we needed to find a new doctor who was within that plan. We did. But it was a huge hassle. Keep in mind we were a family of four (Mom, Dad, two kids) who had simple, minimal health care requirements/issues.

But, to repeat myself, it was a huge hassle. Luckily we had no major health issues, and about two years later, as best I recall, the health care plan changed and we were able to return to our earlier doctor. But it was inconvenient. And I think various records were lost in the process, specifically vaccination records for our sons.

I know, it could have been vastly worse. I joke that I have the Republican Health Care Plan which is I don't get sick. Luckily for me I really am incredibly healthy. A combination of good genetics and lots of sleep (I honestly think that the fact I've tended to get enough sleep over the years is a genuine factor in my good health, but that's a topic for a different discus ion) and perhaps simple good luck is at work.

As someone with incredibly good health and no chronic diseases, I am enraged at what others put up with. I don't care if you've been smoking two packs of cigarettes a day since you were thirteen and are currently obese and have diabetes and kidney disease and I don't know what else. It doesn't matter at all if your health condition could have been prevented by living a better, healthier life. What I care about is that you, and everyone else, get the care you need. Yeah, you shouldn't smoke and maybe you should lose some weight, but that's not the point. The point is that your health care needs should be covered. Period. End of discussion.

[pnwmom]

2. If Medicare was the only choice doctors would have little choice but to accept it.

But the situation now for Medicare patients isn't as bleak as you think. About 9 in 10 take Medicare, with some variation depending on specialty.

Overall, 87 percent of family medicine physicians are taking new Medicare patients, a bit lower than the 91 percent average among all docs. But among specialists, 99 percent of general surgeons and 98 percent of orthopedic surgeons take new Medicare patients compared to only about 63 percent of psychiatrists.

https://www.forbes.com/sites/howardgleckman/2013/12/18/there-is-no-shortage-of-doctors-willing-take-medicare-patients/#73785a84816b


HOWEVER, I agree with you that we'll scare people off if they think we're taking choices away. So I think our best bet is still the step-by-step approach. First add a public option, as we're going to be adding in Washington state. Then, assuming it works well, a public option will draw more and more people over time. Eventually, it can become the plan for everyone.

[Recursion]

3. That article is from 2013

It's down to 81% now

[pnwmom]

5. What link do you have that's more recent? n/t

[Liberal In Texas]

7. I've been on medicare for 5 years, I've never run into a doctor that wouldn't take it.

I supposed they're out there, but not in my experience.

[BigmanPigman]

4. I think you're onto something here. Makes sense to me.

[watoos]

6. What kind of health insurance do you have?

[Recursion]

8. Aetna. It's a very confusing plan

Inevitably, it says "yeah, go see whoever, it's covered" and inevitably the office sends me a huge bill. I'm not clear what Aetna is actually doing for me at this point.