Charles, Let's pull back the curtains on this big lie. THE FACT IS the republican plan INCREASES Medicaid spending by 20% by the tenth year! Only in your wacky world could you frame this increase as a decrease simply because it doesn't increase enough for you. Competition among docs is a challenge in rural areas but in our larger cities it exists and our gov should be much better at promoting it. Allowing the only two cardiology offices to merge to form Ak Heart Inst produced very predictable results! And more recently our two largest orthopedic clinics. Disgraceful inside deals.