Posted at the
Incidental Economist blog:
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What many seem to miss, over and over, is that we’re not debating between giving the uninsured Medicaid or private insurance. We’re debating between giving them Medicaid or nothing...Most of the physicians who oppose the Medicaid expansion would rather see privately insured patients than Medicaid patients. That’s their right. But lots of physicians, and most hospitals, don’t have that luxury. They’re choosing between uninsured patients and Medicaid patients. Some payment is better than none
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Which is unimpeachable economics. What it might leave out is, on the one hand, the social status aspect, and on the other, the opportunity cost, as one of the comments left at the site points out:
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Private practices are concerned that if they become known as a provider for Medicaid, they will get flooded with appointment requests that can crowd out the better reimbursing patients
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Of course, none of this matters in a hypothetical world of Medicare-for-All, and eliminating these perverse incentives on a practice's decision-making might be one of the best minor consequences of that more-or-less inevitable next step to healthcare reform.
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