As a doc, I don't get how vouchers are supposed to work. Are the insurance companies supposed to be induced to play hardball with me and make me settle for less money? That ain't gonna happen because my waiting room is full to the brim with patients with private insurance, which pays more than Medicare in the first place. So if they try to play hardball, I will simply decline their offer politely but firmly. I see Medicare patients only out of the goodness of my heart. I don't see Medicaid patients because I guess my heart isn't that good.
There's a primary doctor shortage going on in most parts of the country. We have the payers by the balls.