Here is the new medical model, coming to a city near you.

"Concierge" care.
You pay a flat fee yearly, you get a doctor's cell phone number with an invitation to call day or night, a customized wellness plan and a doctor who promises not to rush through medical appointments.

Think that is too far out?

Look again.

Huntsville Ala.

"Dr. Richard Spera is the city's first so-called "concierge" physician, but several other local primary-care providers are looking to follow his lead.

Spera said his Integritas Medical Institute in Huntsville Hospital's Blackwell Medical Tower has 57 patients who each pay an annual fee of $1,000 or more."

But as more local physicians adopt the concierge model, or simply stop treating Medicare patients unless they pay an annual fee, patients who cannot afford the steep fees could have trouble finding other doctors. Most established family physicians and internists in the Rocket City won't accept new Medicare or Medicaid patients.

http://blog.al.com/breaking/2010/08/local_doctors_begin_charging_f.html#incart_mce

The trend is to NOT accept Medicare or Medicaid.
A patient has to PAY just for the "privilege" of being accepted as a patient.

many years ago, some might argue that with my sanity too.

Oh wait... :(

on their own in America. I do remember arguing about the Medicaid expansion in HCR, which is not a bad thing, per se. Many here disputed my words that there are many areas of the country where Medicaid patients can not find doctors to treat them. This is true and I expect it will get worse as the ranks of the poor continue to grow.

Makes more sense to put the money in a savings account and use it for the Dr.

But yes, just as some predicted once the real health care reform plans were visible, we will end up with
those who can afford care and those who cannot, with very very limited choices for those who cannot.
The state and Fed. government will be able to eliminate, over time, most of the Medicare/Medicaid costs
since few Dr.s will accept patients on those plans.
Medicare D for drugs? I don't think Big Pharma will let go of that plan easily, it is still a gold mine.

This is a big part of the problem with the medical profession - especially in the South. There is a population down here that needs Medicare and Medicaid to even get treatment. And then you have these asshole doctors who want to play *Southern Gentlemen* by choosing who can and cannot see them.

Call in ALL the loans -- and if they refuse to see Medicare/Medicaid patients - tell them they cannot practice medicine in the state. Alabama is a poor state -- they don't need doctors who are more interested in being elitist than being actual doctors.

Docs in these towns would starve to death if they relied on only the rich patients.
Down here, an office visit is 56.00.
We don't spend much, yet, on medical costs around here.