Monday, July 13, 2009

"Can you, doctor, be our 'yes man?'"

The decision to opt out of Medicare is often a difficult one for doctors, but for this primary care physician, the decision was worth it (via Instapundit):

This decision meant I might lose my shirt and put my home and small life savings at risk, something thousands of Americans in other professions do everyday. If they could take the risk, then my risk is nothing less than a trivial American story.

The United States was built on this: a country of immigrants fleeing an “old establishment” to build something new. It’s a group of people declaring: “You can’t tax us without representation!” It’s a government that permits us to challenge established norms, challenge power without being jailed or shot. The question today in health care for all of us as patients is will we stampede towards the utopian ideal of “free care” while ignoring the predictable consequences that nothing is free.

The question put to primary care doctors by Medicare is clear at the moment: Will you let us at Medicare regulate care, dictate “best” treatments and control individual health and choices since we know what’s best. Can you, doctor, be our “yes man?”

Eight years ago I cast my vote and opted out of Medicare. Predictably my journey has not been easy but I have never regretted the decision.

Me neither, about a year or so ago, I opted out of Medicare (no easy feat!) due to the paperwork, lack of control, frustration at having trouble getting paid, the regulations and a myriad of other reasons. It was a good decision that I do not regret. If Obamacare comes in, then doctors will have to decide to be "yes men," or "Go Galt" as many health providers are doing.



Blogger TMink said...

The thing I worry about is when the feds say we have to take their payments and bovine scatology in order to practice.

It will certainly come to that.


2:16 PM, July 13, 2009  
Blogger Helen said...


I think at some point, it will come to that. For some of us, we can just bail out, but for others, that's hard to do--especially those who have just started out. Unfortunately or maybe fortunately, they will not know anything better and may adjust...

2:22 PM, July 13, 2009  
Blogger TMink said...

I do see some TennCare as I have to in order to work with abuse survivors. But I do NOT take straight Medicare. The people at AmeriChoice, AmeriCare and Magellan know me and work with me, so I will do some of that.


4:01 PM, July 13, 2009  
Anonymous Anonymous said...

I imagine this would be a more difficult decision if Medicare actually paid market rates, paid in a reasonable time and paid reliably.

4:37 PM, July 13, 2009  
Blogger Sissy Willis said...

Related (you may well have already read this). Patients are gaming the system:

The Massachusetts Health Mess
Massachusetts shows how ObamaCare would really work

6:25 PM, July 13, 2009  
Blogger Sissy Willis said...

The Massachusetts Health Mess

6:26 PM, July 13, 2009  
Anonymous Anonymous said...

Massachusetts did not provide universal healthcare. They simply required everyone to but health insurance from those who have a vested interest in denying legitimate claims and fined those who did not comply.

6:48 PM, July 13, 2009  
Anonymous Anonymous said...

Helen sez: "For some of us, we can just bail out, ..."


Yeah. Huh.

"Some of us ..." are most likely of the female persuasion - maybe the advice you can give to men who are struggling with money issues versus principles is for them to get a husband (or "sap" to use the technical jargon among women).

1:40 AM, July 14, 2009  
Anonymous Anonymous said...

Solution to red tape, bureaucracy and the general frustrating issues of life:

Just get a man to pay for you.

1:45 AM, July 14, 2009  
Blogger Unknown said...

As the only doc in a village, opting out is not an option... Only where there is a population base with a mean income above the poverty level can you opt out... In rural Michigan the mean income is falling...

dr. o

2:43 PM, July 14, 2009  
Blogger geekWithA.45 said...

Another factor that is taking medical prerogative from Dr's hands is the issue of malpractice insurance.

Pennsylvania's medical malpractice insurance has been messed up for years. I don't care spend the time to plumb the depths for root causes, but my understanding is that state level "reform" drove many insurers out of the state some time ago.

This creates a long chain of consequences: A long established small group family practice (In my doc's case, literally a family: Old-Man-Gonna-Retire-Any-Minute MD, Daughter MD and Son-In-Law MD) cannot find or afford malpractice insurance. To survive, they allowed their practice to be bought out by one of our local hospital chains, to be covered under their umbrella policy. As a result of that, nurses who've been with him for 20 years are looking for new jobs, because HospitalCo doesn't pay for employee health insurance, whereas the old private practice did. Dr. X no has to abide by HospitalCo's medical guidelines rather than his own judgement.

The only good thing is that rather than sending my precious bodily fluid samples off to a private lab for analysis for results in 48 hours, the hospital lab will turn results in 24 hours.

5:26 PM, July 14, 2009  
Anonymous Anonymous said...

"Dr. X no has to abide by HospitalCo's medical guidelines rather than his own judgement."


Are the medical guidelines (or more likely ... the situation involved, since it is NOT always just "following the medical guidelines") always worse than the opinion of an individual guy?

That seems to be the conventional wisdom, but is it true?

I've seen doctors really screw things up on their own. Without any help from anyone else.

Sometimes I even get the feeling that individual doctors AREN'T Gods or greater than Gods.

6:38 PM, July 14, 2009  
Anonymous Anonymous said...

This comment has been removed by the author.

7:07 PM, July 14, 2009  
Anonymous Anonymous said...

This comment has been removed by the author.

7:08 PM, July 14, 2009  

Post a Comment

<< Home