Thanks for your support. I still have bad memories from arguing with a particularly vocal advocate for Obamacare on this site back when they were trying to pass Obamacare.

I'd like to add to and fine tune a bit more about the doctors issue.

Anyone who has tried to research when they need a specific kind of doctor should just realize where docs are at if they think of it from the docs' point of view. When you go to a site like ZocDoc, then you look to see what insurance plans the doctor accepts. You often get a list of like 20! If your insurance is on that list, you damn well better call their office to confirm that they still take it! Because all of them have to constantly negotiate with each and everyone of those insurance cos about reimbursements. They might get into an argument about one patient and when that happens a second time, they just decide to stop taking it when the contract comes up for renewal!

With Obamacare, this happens over and over and over. WITH ALL THE MEDICARE ADVANTAGE PLANS, same thing. And most Medicare recipients have them, because they prevent you from having to pay substantial deductibles and co-pays. They do that how? By bargaining down providers' fees and putting all kinds of other requirements on the provider. By supposedly keeping Medicare patients "healthy" enough so they aren't accessing expensive treatments, so they can profit from what's left over. That which Medicare might have simply paid.

Now imagine as a doc having to do this day in, day out, with 20 or more different payers, many with different forms and different kinds of codes, rules, voice mail systems, attitudes....

There is actually a big for-profit race right now in tech development on offering software to downsize the labor issues involved. Here's just one example. Nobody has won it yet. Here's the organization where techies working on such things can get certified. The whole GOP Congress thing has probably thrown all those companies, that whole industry, into a scramble trying to figure out where to go next.

Doctors that have their own practices and other small providers simply must have lots of very knowledgeable staff to handle all of this for them. I can't imagine a single one liking this situation! Why would they? They went into practicing medicine.

The real problem of lost jobs and income here if one went to something more like a single payer system would be all those clerical who have spent years learning how to navigate all the insurance companies. If a doc can manage to hire someone very knowledgeable about that, they can take more insurance cos. and more patients. If they didn't have to do that anymore, those guys and gals' skills are unnecessary. Meanwhile, they got software salesmen bugging them all the time. Along with pharma salesmen trying to get their help getting their new product into the separate approved formularies for each and every insurance co. (There's even software for that--a university doc showed it to me the other day--where you look up if a drug is approved or not by each insurance co.)

From the docs side of things, if we stay with an Obamacare type system it would be better if there were fewer insurance cos. in the marketplace, bigger ones, less competition. This defeats the principle of Obamacare, where there's no upstarts challenging the bigger ones.

If the system is to stay like Obamacare or Medicare Advantage, without everyone using the same software and records and codes and rules about records, and those not continually changing, doctors are going to be unhappy and so are patients trying to get care.

Doctors definitely see this more than patients right now, but more patients will see it as they try to access. Right now here's what we have going on, we are only a few years in: a bunch of people who couldn't access anything at all happy to have bare minimum anything. It won't stay that way, when the primary care guy they have says: well we could solve your health problem, but there aren't any specialists of that type in your plan, or your plan won't allow it.

And make no mistake, all of this is going to affect all the people with employer provided plans! Many in them just don't realize it yet.