Patients with complex health needs and pre-existing conditions are financially unattractive to private insurers, who selectively enroll healthier patients. Private for-profit clinics opt to perform less complicated procedures that they can expedite for higher profits.[i]
Studies have shown that when profit becomes the incentive and different forms of coverage emerge, doctors prioritize the care of patients who have better insurance, resulting in those who are most in need of health care having the least access.[ii]
A “secret shopper” study found that when researchers called medical professionals such as orthopedic surgeons, psychiatrists and dermatologists to request appointments, around 12% were prepared to see a patient with Medicaid insurance and 96% were prepared to see a patient with private insurance.[iii]
[i] Andrew Longhurst, Marcy Cohen and Dr. Margaret McGregor, “Reducing Surgical Wait Times: The Case for Public Innovation and Provincial Leadership” (2016) Canadian Centre for Policy Alternatives, p. 20-21.
[ii] Ida Hellander, David U. Himmelstein and Steffie Woolhandler, “Medical Overpayments to Private Plans, 1985-2012: Shifting Seniors to Private Plans has already cost Medicate US$282.6 Billion” (2013) International Journal of Health Services.