Opting Out of Medicare — Opposing Views

John M. Sherman, MD
Article Type: 
Summer 2002
Volume Number: 
Issue Number: 

Dear Editor,
...In the early 1990s as mangled care and the government began in earnest to take over medicine, I decided I’d had enough.

I’ve always believed that ethical medical care cannot be delivered by a physician who has subordinated his judgment to that of an entity, such as the government or an insurance company, which has a vested interest in limiting or controlling health care. I felt, also, that it was the primary physicians who had the major part of the battle on their hands, as it was they and not the specialists, who were the entry points to the health care system.

Since I had thirty years of practice in a large southwestern city, a practice with no Medicaid and thirty percent Medicare, I decided if there was one primary physician in our area who could opt out of Medicare, it would be me. Thanks to the help of AAPS attorney Andrew Schlafly, I became the first and only physician in my area to opt out of the system on January 1, 1999 — the beginning of an educational, humbling, and discouraging experience.

My wild-eyed guess was that I’d keep about 35 percent of the practice since the actual cost out of pocket for most patients would be peanuts compared to the total cost of each individual’s health care; certainly, a few dollars per visit wouldn’t stop patients from seeking the care of a doctor whom they had known for twenty years or more and whom “they would climb to the top of a mountain to see” — should the doctor move his office there. Forget it; ninety-five percent of my patients departed, most saying, “you’re a great doctor and have taken care of me and my family in a high quality, caring fashion for all these years; pay you? No way, José; Dr. X may not be the greatest, but he’s on the list of providers my insurance company uses.”

The emotional strain of seeing patients whom many times I had “gone the extra mile” for in their care leave my practice many times for nothing more than a perceived savings was very depressing. It did, however, drive home two basic principles: 1) I’m neither as important nor as essential to the community I’d spent years thinking I was —and, attempting to practice in such a manner so as to deserve that status; and 2) The vast majority of Americans no longer value much of anything; loyalty and respect have been relegated to the “vague concept” status and really exist only in a minute percentage of our population. Physicians — no, providers — are public utilities to be regulated and treated with the same distrust and disdain as the water, electric,  or gas companies.

So now, with my retirement fund having been totally depleted, my very nicely equipped office empty of patients, one lone secretary and my wife (nurse) sitting around reading catalogues while waiting for the occasional phone call, and the bills piling up for a fixed overhead that must be paid regardless of any patients, I’ve had to bow to the Hydra, acknowledge they’re all-powerful, and ask permission to make a living.

The prospect of seeing my wife and myself living on $1263 per month Social Insecurity is grim, indeed, a situation I would have thought impossible ten years ago. Amerika — the land of the free, a constitutional republic bought with the blood of patriots, a country that rightfully has been a beacon of hope in a world of dark despair — has been dealt what is probably a fatal blow, not by some hostile foreign despot but from within, by our very own home-grown socialists. I’ve had to re-enter the system, take a job with a large group in the area, and close the practice.

It’s very sad that Amerika’s physicians have been sheep just like the rest of the population, following the voice of their shepherd — the government/corporate managers — as they’re led right over the cliff of freedom into the abyss of servitude.  Voices in the wilderness such as AAPS certainly have done as much as possible to warn the sheep of the slavery that would be the reward for those who refuse to heed the warning and continue to trade their heritage of freedom for short term, perceived gain. Unfortunately, few physicians understood, much less acted upon, the warning. Was it worth it? Probably not. Move over, Dolly — Baa, Baa, Baa!

John M. Sherman, MD
El Paso, TX



Your rating: None Average: 4 (1 vote)

It is now legend the AAPS legally lanced the secret task force and pulled its secrets...into the sunshine. It destoyed the Health Security Act.

The Oath of Hippocrates
and the Transformation of Medical Ethics Through Time

Patients within a managed care system have the illusion there exists a doctor-patient relationship...But in reality, it is the managers who decide how medical care will be given.

Judicial activism...the capricious rule of man rather than the just rule of law.

The largest single problem facing American medicine today is the actions of government...

The lessons of history sagaciously reveal wherever governments have sought to control medical care and medical practice...the results have been as perverse as they have been disastrous.

Children are the centerpiece of the family, the treasure (and renewal) of countless civilizations, but they should not be used flagrantly to advance political agendas...

Prejudice against gun ownership by ordinary citizens is pervasive in the public health community, even when they profess objectivity and integrity in their scientific research.

The infusion of tax free money into the MSA of the working poor give this population tax equity with wealthier persons...

It was when Congress started dabbling in constitutionally forbidden activities that deficit spending produced a national debt!

Does the AMA have a secret pact with HCFA?

The lure of socialism is that it tells the people there is nothing they cannot have and that all social evils will be redressed by the state.

Canada's fatal error — Health Care as a Right!

The Cancer Risk from Low Level Radiation: A Review of Recent Evidence...

...Moreover, the gun control researchers failed to consider and underestimated the protective benefits of firearms.

Vandals at the Gates of Medicine — Have They Been Repulsed or Are They Over the Top?