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One impact I've seen in my own family (my father is a practicing OBGYN/doctor) is that the influx of foreign doctors lowered the wages of many doctors here long before Obamacare due to insurance agencies. Basically a doctor from some foreign country would open some crappy OBGYN office in a strip center, by some used medical equipment, and start seeing patients. The insurance companies would work with them to see how much they charge for exams, procedures, delivering babies, c-sections, etc and they would all have low rates. The same insurance companies go back to guys like my dad and say that he needs to lower his rates if he still wants his practice to receive patients from their insurance company. Some plans he had to just tell to take a hike, many he was able to work with, but still wound up taking a lower rate. The end result was that he had to work twice as hard in 2000 as he did in 1980 for the same amount of money. Not the same amount adjusted for inflation, I mean he had to work twice as hard for $100 now than he did then. When Obamacare passed he finally gave it up and became a hospitalist. Him and some of his partners started a little hospitalist company dealing with hospitals that have a need for OBGYNs. Now he works Sunday through Tuesday and makes the same as he did in private practice.

That's the concerning part. As more and more doctors move away from private practice and in to working for hospitals people's choices will rapidly degrade. I can see in my life time a point where whenever you're sick or just need a check up, just just go to the hospital. Whichever doctor you see will be somewhat luck of the draw based on what day it is. Many US doctors can't and just won't continue to practice with insurance companies continually trying to pay them less and less.