FYI last night at the Great Falls Grange debate, Democrat delegate candidate Kathleen Murphy said that since many doctors are not accepting medicaid and medicare patients, she advocates making it a legal requirement for those people to be accepted.

She did not recognize that the payments are inadequate to cover the doctors' costs. She also did not recognize there is a shortage of over 45,000 physicians now and that it is forecast to be 90,000 in a few years.

Democrats appear to want to make physicians slaves of the state, but Democrats don't admit they would just drive more doctors out of practice into retirement and other occupations. The Obamacare law and regulations are causing millions of people to lose their health insurance, drop many doctors and hospitals. The HHS internal forecast is 93 million Americans would lose their health insurance due to the Obamacare law and rules about adequacy of insurance.

Many more people will be uninsured. The penalties for being uninsured start at $95 per year, but the penalties can't be collected by the IRS if a person does not have a tax refund to attach.

The out of pocket costs required by Obamacare's Silver Plan for a non-smoking mother and father with two children making a gross before income taxes of $50,000 (roughly average salary for VA) would be $13,765 per year including the deductible of $10,400. That's 28% of their gross income -- not very affordable and about the same as guidelines for a mortgage payment. For such a family making $100,000 of gross income, The cost would be $21,431 including the deductible of $12,700, or 21% of gross income.

With such high deductibles doctors are stuck with trying to collect cash from the patients, even at regulated charge structures. Thus is makes sense for primary care doctors not to participate in Obamacare, medicare and medicaid. They should encourage patients to participate in Concierge Care and insurance programs run by the doctors themselves with patients who can do simple math. Patients can take out catastrophic insurance with high deductibles for major surgeries. Tax deductability for individual medical savings accounts would make health care more affordable.





The head of Obamacare programs, Berwick, loves the socialized medical system in the UK, but never mentions that malpractice insurance is minimal. In the UK, panels of doctors review and approve malpractice awards, rather than emotional juries misled by trial lawyers. Malpractice reform like this with caps on malpractice awards would go a long way in making health care affordable.

I hope physicians rise up and speak out for common sense, protecting quality medical care in the US and giving patients freedom to choose