We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
It is not just the compensation that discourages physicians, especially internists and pediatricians, from working for the government (eg Medicare, Medicaid). A major issue is the paperwork burden. The government paperwork requires a specialized back office staff which only large practices can afford.
If there are any doctors in my area who don't take Medicare I'd be astonished. We have a very large older population so not taking Medicare would be like signing your own death certificate businesswise.
On the other side my GP and I talk about this all the time and he doesn't take Medicaid and says few good doctors do. He told me their payment won't even cover his the costs of his office staff much less overhead and something for him.
He also quit seeing patients from CA and Illinois with state health insurance since CA sent him IOUs and IL just didn't pay at all.
The whole Medicare mess is made possible by the fact that price comparison is impossible. Every doctor should be required to list his prices for the hundred most common billing-codes in his specialty. Then you can develop "Dr. Yelp" style websites that compare the prices for each doctor; both domestically and internationally.
In Mexico, medical services can cost as little as one-tenth of what the same services would cost in the United States. Flying to Mexico city is cheap.
Up here in the land of single payer and Medicare, it's much worse.
The government controls how many doctors can get jobs.
They control where the jobs are. If you want to work in a large city in Quebec, be ready to take a 30% pay cut, assuming you can find a 'PREM' ( Physician Regional Plans aka permit to work )
A doctor cannot charge for a service offered by the government unless they opt out completely. Few do.
The government keeps squeezing the doctors. They require them to provide care but refuse to pay them for their time.
It's on ongoing struggle.
So we have waiting lists. 6 months to see a dematologist is normal. 8 hour waits in the hospital emergency room is normal.
..and we still pay thousands for healthcare... It's just hidden in the taxes we pay.
It's bad enough that the government controls healthcare, but in addition, all physicians have become civil servants.
Healthcare workers are burnt out. The hospitals are broken and unable to deliver cost-effective care. There is little incentive to be 'better', since that will just mean a lower budget or more patients...
My father had a medical practice from 1970 - 1995. From 1970 until maybe 1985 or so, a staff of one was able to run things. By 1995, two additional people were needed just for the insurance, etc. paperwork.