They pull out of the marketplace but have no problem with being the 'handlers' for huge juicy medicaid contracts. The problem with the ACA is the huge amount of bloat it has. You cannot get a plan, for instance, without birth control or without primary care visits. I suppose the free market solution will be for the so called concierge care with emergency coverage. But in reality, that just creates even more maldistribution.

Right now we, thankfully only see two tiers when it comes to outpatient care, but one has to believe it will come to inpatient as well eventually. Theres no free lunch, you can keep writting mandates that 'providers' must show their quality thru ever increasing paperwork bloat with decreasing reembursment, but eventually they will opt out. Many offices already have 'caps' on the amount of hmo/medicaid pts they will see (if they see them). It will look like everyone takes the insurence when no one does.

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