No they won’t. This is already happening in hospitals with specialists who have gotten tired of being stiffed nearly every time they are called to consult in the hospital or by the ER. That is what is driving these doctors to affiliate with surgery centers and specialty hospitals that don’t run emergency rooms.

You are whistling in the dark with your ideas that “there will always be people who will be willing to do that kind of work.” You indulge yourself in your own illusion that because things have worked so far that they will always work out (well even). There are minimum standards that doctors and caregivers have to meet, and expecting availability at sweatshop prices isn’t going to work.

Doctors don’t appear to fill every void as if by magic, even from India and Nigeria.

Accepting insurance is optional, but few patients with insurance will choose to go out of plan, even if they express a preference for an out-of-plan doctor. If there were such a thing as accountancy insurance, I am sure the same would apply there. Most patients with insurance see coverage not merely as indemnity but as an entitlement to not have any concern about costs or payment. Insurance companies sell their plans that way: go anywhere you want, no worries.

As for Medicare, the other poster is right. To have hospital privileges (and even a state license in some states) you have to participate with Medicare.
No, i don’t have to take assignment, but for hospital physicians, that isn’t always an option that allows a viable practice. Sure, you can try. You will go bankrupt.

With Medicare, I am not allowed to offer some of my services at the allowable rate but not others, even if those are market-competitive rates. I have to “opt-out” by written contract with that patient and by law, if I do so, I am also required to opt out with every patient who has Medicare for two years following. That is if I provide even one service to one patient. I am not allowed to price to my market. Worse, when I “opt out”, my patient gets no payment of any kind from Medicare, not even the amount they would have paid them had I not opted out. So the U.S. government, which taxed this beneficiary for support of Medicare is robbing the patient of his benefit, and is severely penalizing his freedom of choice.

” Insurance acceptance is certainly optional, in the same way eating is optional.”

People pay lawyers, engineers, accountants, etc. all without insurance footing the bill. None of those are cheap. The problem is you’ve been stuck in the system so long you don’t know any other way.

Try to understand something. Medicare patients will receive NO HOSPITAL CARE when docs drop out of the system. If that’s what you’d like, then fine. But when you are the Medicare patient in shock and on a vent, and there’s no one to take care of you, I wish you luck. And, by law, you’ll have to be on Medicare.

I don’t see where there is an argument for free stuff, only the argument that if payers want doctors to buy expensive stuff, then they should be willing to pay for that stuff, or else be content with the stuff they are paying for now. And when the trend is to pay less, and certainly not more, don’t expect doctors to willingly embrace expensive technologies that don’t offer any benefit to those bearing the costs. Why that is so hard to fathom is difficult to understand; people scream bloody murder when their taxes go up without receiving improved services so why should this be any different? If patients really believe safety is improved by having EMRs, then vote with your wallets and pay for them.

You have a choice to spend more of your time lobbying your representatives for a better way of paying you, something you’re either not doing enough, or not doing very effectively.

And you’ve got a choice to do something different with your life. Unless you were practicing medicine in the 60s you knew, or should have known, the deal when you signed up to get paid by the government. Your predecessors made this deal with the devil, and you chose to follow in their footsteps. And now all you do is bitch about the deal you cut.

Man up and do something besides bitch or get out of it. Begging for more free stuff from the government like Kevin is doing won’t get you far.

You ever notice that there are people who comment on this blog who don’t understand that if the government mandates something like EMR, Uncle Sam should pay for it? Why should docs lose money implementing a system that hasn’t proven itself to work?

And these same writers think we willingly don’t want to be part of the free market. Geez, if only Medicare would allow me to take care of elderly patients outside “the system”….