A doctor who won't take any insurance or Medicare? Yank their license, plus imprisonment.

[Ms. Toad]

187. Medicare and Medicaid are government programs.

But if you want to look at them as if they were insurance, each is the equivalent of a single insurance company. So using rejection of Medicare/Medicaid no more illustrates that doctors are going to a cash only model than does a doctor's rejection of a single insurance carrier.

Most doctors can, and do, pick which insurance carriers they will contract with. If the benefits aren't high enough, or the paperwork too onerous, doctors will reject that relationship. Doctors rejecting Medicaid or Medicare are doing the equivalent of rejecting a contract with a single carrier, while still accepting one or more other insurance carriers.

That is not the same as a doctor refusing to accept insurance at all (or going to cash only) - which is what you have been saying will be a problem with Obamacare. Under Obamacare people (both poor and wealthy) will have a variety of insurance providers to choose from and while it is almost certain that individual doctors will reject relationships with some insurance companies, very few will reject relationships with all insurance companies. People who are responsible for choosing their own insurance provider will need to choose carefully to make sure the one they accept covers their doctor - or the plan they can afford doesn't include their doctor they may need to switch doctors, just as I do now (and I occasionally have to now and I have very pricey employment provided insurance.)