Conundrum: Who should care for the dermatologic needs of the medicaid patient? Facts and controversies

With the impending implementation of Obamacare in the context of a depressed American economy; an unsustainable national deficit and debt; and increasing personal dependency upon government largesse, a perfect storm is developing in the United States. This perfect storm is embodied by the paradox that an expanding population of Title XIX insured patients is increasingly dependent upon a diminishing number of American dermatologists to provide essential dermatologic care. In this context, we discuss whose responsibility it is to care for the dermatologic needs of Title XIX patients.