Author Affiliations: New York County Medical Society and Department of Surgery, Mount Sinai Medical Center, New York, New York.
Proponents of the Patient Protection and Affordable Care Act (usually referred to as the Affordable Care Act), which aims to cover some 32 million uninsured individuals, would do well to ask whether physicians will care for these individuals once the act is implemented. Most physicians provide care for some uninsured or poorly insured patients, relying on payments from insured patients to cover the shortfall; private practice physicians are the main source of care for the uninsured and poor.1,2 But recently physicians have become less likely to provide such care “because their practices are being squeezed by steadily declining insurance reimbursement on the one hand and sharply rising operating costs on the other. These pressures make it increasingly difficult to see patients who cannot afford to pay—or, in the case of Medicaid, patients for whom payment rates are often inadequate.”2
Zinberg JM. When Patients Call, Will Physicians Respond?. JAMA. 2011;305(19):2011-2012. doi:10.1001/jama.2011.661