Universal HealthcareBy NextBestFit
Phase 1: Enactment & build · Step 1.6

Sign up providers & set participation rules

Months 6–18 · UHA Provider Enrollment; state licensing boardsDiscuss this step
capacitylikelihood: mediumimpact: high

Physician early retirement and opt-out

Specialists facing fee cuts retire early or move to cash practice, shrinking capacity just as demand rises.

Early warning signs
  • Opt-out filings
  • Medical licensing renewals
  • Specialty-specific waits
Mitigation
  • 4-year rate convergence
  • Specialty-specific adjustments
  • Removal of administrative burden as a non-financial benefit
marketlikelihood: mediumimpact: medium

Cash-only concierge tier grows

Opted-out physicians serve the wealthy for cash, recreating two tiers and draining capacity.

Early warning signs
  • Opt-out rates by region and specialty
Mitigation
  • All-or-nothing opt-out
  • Duplicative insurance ban (cash only, no insurance)
  • Rates competitive with cash practice

Implementation risks

RiskMitigation
Mass opt-out in specific specialties or regions.Monitor opt-out rates by specialty and region monthly; targeted rate adjustments if any specialty exceeds 10% opt-out; wait-time guarantee pays opted-out providers at 150% when UHP can't meet waits.