Fed up with shrinking reimbursement rates and increasing bureaucracy physicians are withdrawing from the Medicare and Medicaid systems. Look for this phenomenon to spread as more and more physicians become feed up with a system that treats them like indentured servants, until enough physicians’ have withdrawn from government-sponsored health care (including “private” HMOs which are actually the result of Nixon-era policies mandating private health plans adopt the HMO model) to establish a de facto free-market in health care.