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	Name:	copperline -
	Subject:	Squeeze
	Date:	2/28/2012 1:45:24 PM

I'm mostly familiar with the part of Medicare/Medicaid/Tricare in outpatient medical practices. Many MD's already refuse Medicaid because of low reimbursement rates, Tricare remains only mildly attractive to the majority of MD's who do outpatient care...but avoided by inpatient MD's & hospitals. It's predecessor, Champus, was widely avoided by all, but the system is improved now. Medicare is still accepted broadly, of course, but only because it is so large... not because of reimbursement rates. It's impossible for an MD to predict what Medicare will reimburse for a given procedure... this can vary from event to event without explanation. Faced with that unpredictability, many clinicians simply say it's too much trouble to participate.... and more are opting out.

I expect that continued cuts in federal funding will result in Means Testing for recipients in the future.... whether it be Social Security, Medicare... or Tricare, federal worker or military retirement programs. It seems to me to be the only way to make such deep cuts.