Medicaid crisis in Washington
I'd like to add just one thing. In medicine, market forces, for the most part, do not determine charges. In effect, the government determines our rates of reimbursement. Most HMO's, insurance companies, and third-party payors start their negotiations over reimbursement rates for doctors, medical practices, and hospitals at the Medicare rate. Usually, the contracts end up being somewhere around 100-130% of Medicare (although occasionally, particularly hard-nosed insurance companies have managed to negotiate rates below Medicare reimbursement). In addition, Medicare rates are not even keeping up with inflation, and for some procedures they are even being cut. However, expenses keep going up, and malpractice insurance premiums keep going up; but, unlike other professions, doctors have a very hard time raising their rates to cover their increased costs. That may mean that, soon, the crisis in access to care for Medicare patients could spread to those of us who think ourselves safely insured.