heimesheyid,
“1) the top specialists will look elsewhere for work since it wont be worth it for them with this new healthcare plan?”
Already we see “top specialists” refusing many insurance plans. The new law will not change that (for better or for worse).
“2) Waiting times for specialty doctors will be much longer since the incentive to please will be lost?”
The waiting times will be reduced from forever to finite if today you are one of the millions of uninsurable Americans. But in any case it isn’t clear that the US needs anywhere near the number of specialty physicians it now has. The New York area has far more specialists than do other parts of the US, but it isn’t any healthier than many of those other areas and health outcomes aren’t any better. Other countries have even fewer specialists yet have better outcomes. For all the common serious chronic diseases, a well trained primary care physician can manage patient care just as well as specialists, who really are needed only when the patient does not respond to standard treatment.
Also, it is not clear that how pleased a patient is with his/her physician has any association with health outcomes.