Opting Out of Medicare — Opposing Views

Author: 
Katharine C. Otto, MD
Article Type: 
Correspondence
Issue: 
Summer 2002
Volume Number: 
7
Issue Number: 
2

Dear Editor,
I opted out of Medicare three years ago because I could not participate in that pathological system and still practice good psychiatry.

I learned in residency that paying for treatment motivates people to improve. They are more inclined to communicate, cooperate and comply. They make the most of their visits and need fewer of them. They are empowered to make conscious choices about how to allocate their resources.

Unfortunately, the Medicare, third-party payer and socialized medicine factions work in opposition to this fundamental principle. They reward infirmity and feed dependency. They are creating a whiny and debilitated populace that has forgotten basic self-respect and common sense.

Our current system disconnects the patient from the cost, creating the illusion that others are more responsible for his health than he is. Meanwhile, we have brainwashed ourselves into believing insurance is more valuable than health care itself, but we all know insurance doesn’t guarantee — and often obstructs — good health care.

Not only have I opted out of Medicare, but I have resigned from all managed care contracts. My patients understand up front that they are expected to pay me at the time of service. Thus, money issues are properly addressed in the therapy room, and patients’ experiences with their insurance companies become teaching tools.

I will not get rich doing business this way, but I am doing the job I was trained to do. Also, I have very low overhead, very little stress, and I don’t have to worry about the Medicare police barging with guns into my office and traumatizing my patients.

At this point I have diverged so far from the mainstream there is little hope of return. People like me, who choose to be healers rather than “providers” (read “enablers”) are a dying breed. There are more of them than there are of us, and they have louder voices, more money and more political clout.

But that doesn’t make them right.

Katharine C. Otto, MD
Savannah, GA

 

 

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