Unbeknownst to most people in or out of the healthcare arena, however, are the legal options available to physicians to either never enroll in Medicare or to voluntarily withdraw their participation in the government’s plan. The legal nuances of the doctor-Medicare relationship may shed light on options available to physicians to skirt inclusion in Obamacare if the law’s enforcers decide to use a heavy hand in mandating their participation.

Quoting a memorandum by the California Medical Association’s Solo/Small Group Practice Forum delegation on January 9, 2012, physicians became aware of a “bulletin circulated by the American Medical Association [referencing] an email authored by an unidentified Center for Medicare and Medicaid (CMS) employee who stated that a non-enrolled physician who treats Medicare beneficiaries must either involuntarily enroll in Medicare or else provide medical care free of charge. Apparently some embrace conscription of physicians and believe that the federal government can require physicians to work for free.”

The real challenge for physicians today is that they lack true representation by the American Medical Association (AMA). Since the AMA’s membership represents only about 15% of practicing community doctors in America, and since the AMA lost 12,000 member doctors in 2010 alone (and are expected to have lost at least that amount in the year 2011), the AMA has a real credibility problem with the nation’s physicians.

Furthermore, since the AMA publically signed on as a supporter of the Patient Protection and Affordable Care Act (PPACA) with only the implicit blessing of their limited membership, and many local and state AMA-affiliated medical societies remained eerily quiet during and after the contentious health care reform debates, the vast majority of doctors feel the organization betrayed them. America’s doctors need true representation to the public and to their elected representatives. Without proper representation, doctors are looking for ways to simply opt-out of all government health care plans.

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