A letter from a sane doctor, posted at The Corner on NationalReview.com:
March 23, 2010
My Dear Patient,
As you must know, Congress has just passed extensive legislation governing health care delivery and insurance systems. Whether you agree with what it does or not, we are all now subject to this law and its sweeping changes.
I have always conducted my medical practice with my patient’s best interests as my first priority. Although not legally obliged to do so, I have routinely provided you with a receipt that has all the codes necessary to bill your own health insurance company for any reimbursement to which you are entitled. Until now, that insurance company was a free enterprise despite the fact that it was heavily regulated by state and federal laws. Now the situation is quite different. Through the new law’s mandates, regulatory powers and reform, health insurance is and will be largely a government activity which will have an ever larger jurisdiction over how doctors practice, make clinical judgments and are paid.
The new law provides for about 150 new government agencies, many of which are designed to be ‘oversight’ bureaucracies which will have the right to decide what medical care is legal to provide through insurance. Among other things, they will have the right to review my medical care of you and read your medical record. Now, as soon as you submit our economic transaction to your insurance company for reimbursement, you have involved me in these regulations and put me in the jurisdiction of government for my activities, decisions and behavior as your doctor.
No one can have two masters. Either I can serve you as my patient or I can serve the government. Either I can continue to make your welfare and health my only concern, including the protection of your privacy and medical records, or I can abide by ever-increasing amounts of government regulations and dictates to my decisions. I can’t do both. I choose to continue to follow my conscience and practice medicine to serve you.
For this reason, I am responding to the situation created by this new law by exercising my right not to participate in any health insurance program. I will still provide you with the same medical services that I always have, but the interaction will be exclusively and privately between you and me. This means that I will provide you only with a receipt for the services you have paid for, but without the additional information that is required to submit your receipt for reimbursement to your health insurance company. That is the only way I can make sure there will be no conflict between following the law and serving you. Because the law is now in effect, so must these changes be to my practice.
Linda Johnston, MD
My own personal physician, Dr. John Madden in Glendale, Arizona, operates as Dr. Johnson describes her past practice: Cash on delivery of services, with a detailed receipt for insurance reimbursement billing — which you can undertake on you own if you like. We never bother with this, since our deductible is far in excess of any charge we ever have to pay. But I wonder is this is what he will do now. I hope so, frankly, because my quiet fear, all through this health-care “debate,” has been that he would retire.