Representative Peter Cook got me to thinking after he reported that all Congressman have private insurance. So, obviously that will remain for all who can afford it. No public option for Congressman.

So, here's how I think it will work.

The public option will literally drive physicians out of practice. The “reform” is pure nonsense in the end. You want real reform? Start with tort reform. That's not going to happen so there is no real health care reform to anticipate. That's delusional.

Let's take a look at the future.

"My malpractice is rising and I can't readily adjust for the new premiums, which seem to come monthly. There's no tort reform. I cannot afford to maintain a practice with too many older patients. They are sicker, require more tests, and Medicare is scaling back. The public option is even worse. It reimburses at the Medicare rates, and I am required to accept it. The paperwork is enormous! I have to hire extra help to handle it. And there’s always questions; there’s always hassles. I can't deal with this. I have higher expenses and lower income, with greater risk. It doesn't make any sense."

-- comments of a hypothetical physician under the "reformed" health care

No, it does not make any sense. Physicians will be a prime target under Medicare or the public option. Those who administer "too many" tests will experience cuts in Medicare reimbursement. The end result of “reform” will be fewer doctors; longer waits; incompetent HHS management; health care rationing on a scale that far surpasses anything we have seen (Ezekiel Emanuel type rationing perhaps); and of course higher death rates. Longer waits and delayed diagnosis translates into death for some patients. Rationing of health care translates into death for many patients

The solution for these physicians? Well, now, Congress will mandate that you don't have to accept the public option provided that you do not accept any Medicare patients ---100% private insurance Only exempts you from the public option. Of course what this really means is a two-tier health care system. One that serves Congressman and one that serves their constituents. Now, no one has spoken about this yet. But it doesn't matter. You only have to understand the way of the world to know and predict how things will be. One health care system for Starkist Nancy Pelosi and another for me. Surprising?

Here are the stats from a survey: 12% of doctors have already decided to stop seeing Medicare patients; 39% of doctors will limit the number of Medicare patients that they treat if there are further reimbursement cuts in Medicare; 19% will stop accepting new Medicare patients; 33% will no longer see Medicaid patients.

The survey is prophetic and it's just the beginning.

Just what do you think will happen if physicians are required to accept the public option, which by the way will throw the Hippocratic oath under the bus? As Ezekiel says: physicians are too serious about it. They will leave medicine or convert to a practice that serves only private insurance patients.That generally means that they have to practice in an affluent locale. They can't do that with a practice in Ten Sleep, Wyoming but could in Washington, DC. Do you get it? A two tier health care system is an inevitable outcome of the public option. It simply cannot be any other way.