Many Doctors Opting Out of Medicare


This NY Times article notes that many patients who become Medicare eligible are finding that the “insurance rug has been pulled out from under them.”

More and more physicians are dropping Medicare and patients can’t find physicians to take care of them.

“The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.”

There is already a shortage of internists in the US and the ones that are available are unwilling to accept new Medicare patients. Universal coverage doesn’t mean much if no one takes your insurance.

The more I think about this, the more I wonder whether this is exactly what the feds are looking for. They keep taking 15+% out of everyone’s paychecks to fund a Medicare system that fewer and fewer doctors participate in – until everyone pays a lot of money to end up with little or no access to medical care.


  1. WC – The only reason we Docs can opt out of Medicare is that there are other plans to bill. My worry is of the Hawaii kids care scenario. The Government sets up a plan so cheap that everyone jumps to it, and drops private insurance. Private plans quickly disappear, What would the medical community do when faced with the alternatives of take cash or take the government health plan that insures all the people?

    • Then we have the British system where there is the National Health docs, and then the cash pay private system. If your community has enough cash paying people, you can eek out a living.

  2. And when people end up “with little to no access to medical care,” the government will come to the rescue with mandatory socialized medicine, the solution to the problem government created.

    I see a pattern here.


  3. I am going to take two excerpts from Dr Donald Barr’s (MD, PhD) book Introduction to U.S. Health Policy that shows two disparate positions regarding this autonomy in more detail. The first is from Dr R. M. Sade and was published in the New England Journal of Medicine in 1971:

    “Medical care is neither a right nor a privilege: it is a service that is provided by doctors and others to people who with to purchase it”.

    On the other hand, we have the position of Dr. John Bowman who released this statement in 1918:

    “As a people we are accustomed to hospital service; we look upon that service no longer as a luxury which we may buy, but rather as an inherent right…we regard the right to health today as we regard the right to life”.

    In the former view, either you have the money to pay what a doctor will charge or you don’t. These are the doctors who feel they shouldn’t have to comply with a system that won’t let them freely charge what they wish. The latter view suggested that we should all be able to receive care when necessary. If that means accepting a discounted rate on services or supporting a single-payer national insurance system than so be it.

    I interpret the former view as one that flirts with selfishness. And being a doctor requires a bit of something quite the opposite: selflessness. The motivation to be a doctor seems that it should stem from wanting to help others even when the price isn’t right. Although I understand, not everyone can walk around wielding their services for free. No one can live off of that, and certainly no one expects their doctor to work for free.

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