Historically physicians felt it was their duty to care for indigent patients and were able to do so because insurance company's paid a reasonable reimbursement.  With the advent of HMO's and indexing of payments to medicare the margins for physicians were significantly reduced making it impractical for them to continue free care.  The reason physicians accepted medicaid and medicare in the beginning was out of a sense of duty to the poor and elderly.  They never suspected that it was the camel's nose under the tent and everything would be indexed to those payments.  In other words no good deed goes unpunished.

Ostensibly the purpose of Obama care is to make healthcare available to everyone.  However, there exist still many inherent dilemmas associated with his proposals.  The administration bill calls for a 22% reduction in physician’s reimbursement for medicare patients. Please keep in mind that medicare patients overall are rarely profitable.  This reduction will make them absolutely zero profitable and in many cases physicians will end up paying to see the patient.  The plan has touted that it will cover 30 million more Americans.  You don't need to be a mathematician to understand that if you include 30 million additional people and reduce the number of health care providers willing to see healthcare patients that instead of more access there will be less access.  Therefore this system being thrust upon this country will only increase the dissatisfaction with health care and make matters much worse.

You can't expect physicians to absorb the cost now to care for patients.  They are already burdened with significant overhead and in every case there is increasing exposure to malpractice law suits which this plan offers no solutions for.  For physicians this is a lose, lose, lose proposition which ultimately spells doom for the patient and will discourage many bright future physicians from pursuing the medical profession and will compound the access issue in the future.

The likely outcome is many physicians will seek early retirement and many would be medical students will pursue other careers.  Both scenarios are devastating for the field of medicine.