The desire for liberty in the medical profession — one that years ago sold out to government-run health care insurance — is intensifying with the coming of Obamacare. In Chattanooga, Dr. Carlton Vollberg called it quits Oct. 1, saying he would no longer accept Medicare. Dr. Vollberg says he will continue to accept insurance, and so is practicing a hybrid form of “concierge practice.” A concierge physician is an independent who operates more on a cash basis rather than under price controls and reimbursement schedules.
In South Portland, Maine, this week, family physician Michael Ciampi tells a newspaper about his new life as a doctor in which he rejects relationships with insurance. In a radical surgery that cost him hundreds of patients, he is cutting off third-party payers which over the years caused his prices to be double what they ought to have been.
The Chattanooga physician’s expenses — rent, utilities, lab outlays — kept rising while Medicare held steady in its underpayment of his services. “I’m investing a tremendous amount of time and energy into these patients, and I’m losing money,” he told the Chattanooga Times Free Press. “It starts to feel abusive.”
A concierge practice sets up a variety of cash payment systems. Patients can be a big lump sum at the beginning of a year and have more personal and quicker care. Or they pay cash or check after a visit. It’s possible for a doctor who no longer is obliged to follow corporate or federal diktats to take payments in auto lube jobs, eggs or a new roof on his house.
Dr. Vollberg predicts a mass exodus of doctors from Obamacare. “I’m getting out now, before the mass exodus. *** The system is dead; it doesn’t work.”
Dr. Ciampi posts his prices on his website. A free market is always cheaper than one controlled by giant companies or civil government. Formerly he charged F$160 for an office; now, it’s F$75. After seeing a patient, he receives payment. No staff is required to manage complicated interactions with insurers. “If more doctors were able to do this, that would be real healthcare reform. That’s when we’d see the cost of medicine truly go down.”
Reports a Maine newspaper:
[T]he decision to do away with insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls. ‘I’m freed up to do what I think is right for the patients,’ Ciampi said. ‘If I’m providing them a service that they value, they can pay me, and we can cut out the middleman and cut out a lot of the expense. [Italics added]
Sources: Mariann Martin, “Doctor facing rising costs won’t accept Medicare,” Chattanooga Times Free Press, Sept. 29, 2012
Jackie Farwell, “South Portland doctor stops accepting insurance, posts prices online,” Bangor Daily News, May 27, 2013