Maggie's Farm

What we are seeing here is the strategy to deal with access. Simply put: many physicians do not take Medicare or Medicaid patients because their reimbursements are so poor they do not cover the costs of providing the care. Obamacare pushes large number of patients into the already-bankrupt Medicaid system -- which will have to respond by drastically lowering reimbursements even further, increasing the number of physicians who will be financially unable see these patients -- creating a huge access problem (lots of patients with "coverage", no docs to see them).

The government's solution: bring antitrust actions against the "colluding" doctors, threatening them with heavy fines, enormous legal costs, or jail. Less onerous, although just as coercive, is to tie acceptance of government-mandated fees with medical licensing.

I have always been against unionization of physicians (because it presents huge ethical problems), but I believe this will be inevitable ultimately if physicians are to survive financially. When auto workers "collude" by refusing to work when they deem their wages too low, we call this a "strike", and praise the system as protecting the "working man". When physicians refuse to accept absurdly low payment for their services from insurance companies or government, this is called "anti-trust" and they are greedy, corrupt, and criminals. Something wrong with this picture.

And as for "pulling up your shingle and moving elsewhere": to where? Canada? Mexico? Offshore clinics? This is the Federal government going after physicians on federal health care payments. Nowhere to run, nowhere to hide...