Letters to Obama: Don't decrease Medicare

No matter what you do, be very careful with trying to fund universal medical coverage by reducing Medicare.

In talking with doctors who take care of these patients, the only way they can afford to stay in practice is by other insurance companies paying a higher rate. As of lately increases in payments to primary care doctors has been dismal.

Pediatrics, my field, has been even worse. We are at the breaking point on horrendous vaccine payments by insurance companies. There are a few super specialists that need more doctors, but unless you pay your primary care doctors more equitably, you will not have anybody going into primary care unless they can't do anything else, ie, not the best and the brightest.

Keep using physician assistants at Walgreens, CVS, Walmart, and whereever else they can make a quick dollar on the easy patients, who they still manage to mistreat to many times. You can't take away our easy patients, and leave us with all the difficult patients that insurance doesn't pay fairly on. That will just convince doctors not to enter primary care.

Be careful what you do, because honestly I do not trust government to run a system well. And I do not think the American Medical Association, the American Academy of Pediatrics, and all the other organizations really understand what goes on in a doctor's office. These groups are too political, and everybody just wants to protect their turf. You might say Medicare is well run. But no one in the medical field could stay in business if they only saw Medicare patients. How is that a fair system? Or well run!?

Les Trubow, MD