Congress passed legislation in 1966 that changed the practice of medicine forever. As with most governmental interference with the free practice of business, it has now led to the expensive, inefficient, and intrusive system we see today. And just like most forms of evil, it started slowly and seemed legitimate but has now found its way into every aspect of a once endearing profession. Through Medicare, the government decides who gets care, what care can be given–and what care can’t, and how much the physician will get reimbursed for their services. Let me expain how this works. Medicare reimburses me $52.66 for a $117.50 office call. They “allow” only a portion of that fee to be charged to the patient (say $66.00) and then only pay 80% of that allowed amount. Do the math. When it costs me $65.00 to provide the care, I can’t see any more Medicare patients than I do now. In fact, I should fire all of them, but I have developed relationships with most of my elderly patients so I am unwilling to do that. This has forced me to “cost-shift” the expenses of my practice to my private and insurance covered patients. That raises the cost of medicine significantly. This has been the general practice since Medicare’s inception and look what it has done to the cost of medicine. The government has accepted the authority of patient care for the elderly but not the responsibilty for the financial reimbursement for those services. Now you understand why your lovely mother or father are unable to find a primary care physician to accept them as patients.