Roanoke__You're right, some of those old folks were vets, from all the wars including WW2. Some told me they were on Normandy, or Africa, or China, and more recently Vietnam. I was honored to treat them, and always sad to see them pass on. When I had to close my practice because of the declining re-imbursement and rising costs, it tore me up, but I realised I could not stay open with nearly zero income. This was back in 2004. Nowadays I don't see any old vets, but I take care of active military, younger vets and their family members. They are always thanked for their service, and of course, given a Military discount.

As an MD, I used to participate in Medicare and Medicaid. The re-imbursement was horrible, having no relation to the actual cost of taking care of the patients. Even if it did cover costs, that means I do things without taking anything home. To say that there is anything to squeeze out of provider payments, (other than fraud, obviously), particularly in Medicaid, is absurd. Worse yet, the private insurers look to Medicare for fee guidance, so of course they paid less and less over time too. I no longer participate with Medicare and Medicaid (or any insurance for that matter) and I have been liberated. My only regret is that I miss the people I used to take care of, but I could no longer make ends meet with what they paid. The major problem is Medicare patients pay about $100 of premiums a month for $8300/year of costs, the balance of course paid by taxes. And of course Medicaid patients pay no premiums since they are by definition poor. If the cuts as planned go through, which I doubt, there will be fewer already maxed out providers working harder for their money, a recipe for longer waits to see a Doctor and rationing through payment starvation.