In June, President Barack Obama praised the non-profit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio, as national models for efficient healthcare, offering 'the highest quality care at costs well below the national norm'.

However, as of tomorrow one of Mayo Clinic's primary-care clinics in Arizona will no longer accept Medicare patients, since the government's largest health-insurance programme for the disabled and those 65 and older, fails to offer adequate compensation.

According to Michael Yardley, a Mayo spokesman, if the 3,000-plus Medicare eligible patients wish to continue consulting their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, they should be prepared to pay in cash for their visit. Calling the decision a two year pilot project, Yardley says other Mayo facilities in Arizona, Florida and Minnesota will not be affected by it.

Yesterday, Lori Helm, President of the American Academy of Family Physicians, in an interview over the telephone said, undoubtedly, family doctors, some of whom have already stopped accepting new Medicare patients, will copy Mayo's move of dropping Medicare patients.

According to Heim, many physicians' state business costs simply do not make it affordable to continue looking after Medicare patients.

Lynn Closway, a Mayo spokeswoman said, 3,700-staff physicians and scientists with the Mayo organization treated 526,000-patients in 2008, losing $840-million on Medicare last year.

While, Yardley said, Mayo's hospital and four clinics in Arizona, including the Glendale facility, lost $120-million on Medicare patients last year, as the programme only covers 50% of the cost involved in treating elderly primary-care patients at the Glendale clinic.

In a 23rd December e-mail, Yardley writes Medicare needs to be reformed, as Medicare payments for many years now, have failed to reflect the increasing cost of providing patients' healthcare services.

Further, he said the financial effect of Glendale's decision to drop Medicare patients will be assessed for its implications beyond Arizona.

The Medicare Payment Advisory Commission, a panel responsible for advising the Congress on Medicare issues in its March report states, across the nation doctors made 20% less treating Medicare patients, than they did caring for privately insured patients in 2007.