My Father-in-law is a Urologist who owns his own practice. This week he met with a few members of the state board of medicine about upcoming changes due to the Affordable care Act. I asked him about what changes will be made to his practice. Without even hesitating, he said "We'll have to drop it." When I inquired further, he said "Well, every Medicaid and Medicare patient I see costs me money because the gov doesn't reimburse me like private insurance companies do. The increase in Medicaid to 133% of the poverty line will drastically cut our profits, so why should I offer services at a loss?" It turns out, this isn't an isolated case. All 3 Physicians I shadowed this week (I'm Pre Med) told me they were considering dropping gov insurance. Other than big hospitals who have cheaper operating costs, Medicaid/Medicare don't pay enough to cover the expenses of tests and procedures. The future of Medicine will shift toward large hospitals like IHC. Plenty of aspiring Physicians (myself included) are hesitant to go to school for 12 years and not have the opportunity to be self employed.