In  a public statement, the American Medical Association argued that a public option would be attractive enough to drive out private insurers, causing a "...surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers." While they are wrong in principle about the second point, higher costs, they are likely right about the first. My guess is most primary-care physicians would encourage their patients to shift, in order to reduce the paper and phone calling those offices need in order to collect from the private companies.

But the large number of specialists that are partners with labs and clinics, who see lots of extra income from tests and procedures that are not prescribed in similar situations elsewhere in the country, will in fact earn less. In this I am not wholly sympathetic to their plight. Since most civilized countries have satisfactory staffing levels at hospitals and in offices for visits, there is not an apparent need for this business model. And it is precisely this approach that drives costs beyond the needed into the wasteful range, as exemplified by studies that showed huge cost differences between an expensive town in Texas , McAllen, and the low-cost but revered Mayo Clinic. Atul Gawande details the differences in the New Yorker magazine. Read more »