Chris Rangel with a few ideas:

Part of the reason is that there are few if any protections against liability in treating a population that tends to be less healthy, have more bad habits (obesity, smoking, alcohol, drug abuse), and be less complaint with treatment and follow up. Ergo, they are at higher risk of bad outcomes and bad outcomes tend to lead to lawsuits regardless of any actual malpractice. Remember the old medical school adage; “No good deed goes unpunished.”

But most of the reasons have to do with time constraints. When a physician is doing something for free then during that time they are not creating cash flow to cover their clinic overhead and pay down their student loans, which average almost $120,000. So doing charity care means taking a cut in their take-home pay. Again, no good deed goes unpunished.