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One of the issues that most people overlook is that many physician's insurance contracts are tied into the Medicare fee schedule. For example, a doctor gets a contract with Big Medical Co. and the reimbursement is set at 100% of Medicare. This could potentially lead to nearly 20% cut in that physician's practice across the board. For most solo or small groups (who provide much of the medical care in the US), this would effectively shut down their business and severely limit access to care across much of the US.

Could they increase volume? Doctors are already busy and they themselves are the rate limiting step in a practice - one can only see so many patients an hour.

Could they cut costs? Many physician practices have already made substantial cuts and are operating with minimal staff.

And if you have doctors shutting down their practices who is going to take care of the 34M soon to insured? Which smart college student is going to spend 10+years in training only to graduate with $300K in debt and pay $20K in malpractice per year?

We have a near perfect storm for a true medical crisis in the making - more insured, fewer and under qualified physicians, long wait times and bad outcomes.

Very good analysis ! Thank you very much !

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