The rhetoric of "competition" that single payer fans are using to spruce up the "government option" is deeply deceptive. Many if not most private sector plans will face extinction as they are pushed into a ruinous race to the bottom of the benefits pool by employers studying the bottom line advantage of shifting health care costs to the government. Think about "competing" with Amtrak for passenger rail service and you get the picture of the future of the health care system.
Doctors will quickly have to decide whether to refuse the government plan's rate and rules. Some will, but those with the sunk costs of education and equipment purchased under the old rules will have to try the option of going off the government grid, forcing an immediate fracturing of American medicine into two systems, one for the wealthy and one for everyone else. Right now most of the waiting rooms of America's health care professionals are as diverse as the workforce that is covered by employer-provided health care. Within months of the adoption of a government option, expect many of your doctors to greet your next request for an appointment with the news that he or she isn't accepting the government option.
Beyond that immediate series of dislocations, look for a sharp decrease in the number of talented young people heading towards medical school. Of course many thousands of young doctors will pursue their dreams of being healers regardless of the economics of the out-years of their practices, but only fools will deny that thousands of other would-be doctors will simply refuse to go to work for the government, which is what the government option means for health care providers.
I have written before and repeat again: The country is on the verge of an enormous, culture-changing shift when it comes to the most basic of its expectations with regards to medicine, and yet this potential radical shift is almost wholly unreported on in the MSM in the sort of detail that would allow for an informed debate. Thus is the old media working hand-in-hand with the Congressional left to completely rewrite the rules of healthcare.
Democrats in the House are surely going to face retribution for their breach of faith with their constituents once they experience the reality of single-payer, but that payback is 18 months away. The "government option," by contrast, is on the fast track for passage by early autumn. The GOP has to take up the cause of patient choice and genuine reform, and it has to do so soon.