no reason why he can't continue his policy if he wants to
The federal govt took over this market in 1965. In doing so, there was no reason for carriers to continue offering major med to the over 65 crowd and the Med supp business was born.
You can still buy group health insurance after age 65 but unless you have a large company, the plan will pay secondary to Medicare regardless of whether you have Medicare A & B or not.
In most areas the number of docs that accept Medicare assignment is quite high, usually close to 100%.
Just because they accept assignment does not mean they take on new patients, so you may have to make a change in your current PCP and/or have a challenge finding someone who will take new patients.
Washington is looking for ways to save Medicare (which has been losing money almost since the inception and this year will pay out more in benefits than it takes in in taxes). Limiting how much they pay for services rendered, only paying for evidence based treatment, cost-benefit analysis on treatment protocol will most likely be a factor in the future of Medicare.
With 80 million baby boomer's hitting age 65 in the next 10 years pressure on Medicare will worsen. There are currently 40 million on Medicare, and a number of them will age off the plan before this wave of boomer's hit, but you can see this is a problem that won't go away.
Obamacare does nothing to affect the cost of health care but it does impose at least a trillion dollars in new taxes over the next few years. They won't be able to generate enough tax dollars to pay for all these new and expanded entitlement programs so the flip side is to limit benefits and provider reimbursement.
You can pay cash but in doing so you most likely will pay more than the Medicare allowed charge. You may also seek out concierge practices that do not accept any insurance or Medicare/Medicaid. In exchange for a fee you are entitled to "unlimited" primary care including some lab work (if done in house).
Most of the concierge practices I have seen charge an annual fee in the range of $1500 - $2000 but some have agreed to accept monthly fees.
You should still sign up for Medicare A&B or part C (Advantage). If you opt for Medicare (vs. an Advantage plan) you would be wise to purchase a Med supp as well.
In some areas a Medicare HMO
might be a viable option. In Atlanta Kaiser has a good presence and is expanding the number of offices and providers. The good thing about this type of HMO
is "guaranteed access" to docs.