There’s always something to howl about

My kind of doctor: “I am responding to the situation created by this new law by exercising my right not to participate in any health insurance program.”

A letter from a sane doctor, posted at The Corner on

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.


7 Comments so far

  1. Ashlee Pannell March 24th, 2010 6:53 pm

    Cant wait to see what actually happens with all this new stuff. Be kinda intersting to see what all changes take place whether they be good or bad.

  2. Sean Purcell March 24th, 2010 8:57 pm

    Your fear about your Doc retiring is not so quiet after all. Roughly half the population might want to be concerned with that potential outcome, according to this poll recently published in the New England Journal of Medicine.

  3. Elizabeth Bolton March 24th, 2010 9:00 pm

    There’s little sanity in that letter. In fact if she were my doctor I wouldn’t be back. The insurance industry has been her “master” and she’s worried about “the government”? She sounds unhinged.

    Insurance companies build skyscrapers and pay obscene bonues and salaries by denying care. That’s their business model. Ask people on Medicaire if the “guv’mint” has been denying their care. In my experience the answer will be no – the doctor is the “master”.

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  5. jay March 25th, 2010 6:29 am

    yes if the government take over of health care–notice I did not say “reform” because I have a brain–many docs will retire and many of the best and brightest minds with servant hearts will NOT enter the medical profession thus leading to inherent shortages and much longer wait times for medical treatment and diagnoses. Again that’s one of those duh concepts that supporters of the takeover are unwilling to acknowledge.

    I posted this on facebook yesterday after seeing this cartoon:

    “How can people so blithely forfeit sovereignty of their health care decisions to committees and bureaucrats that inevitably come in the form of batch processing groups of sicknesses or symptoms versus the individual and physician practicing medicine on a case by case basis. CDC has already shown itself to bed with pharma companies pushing … See Moremedically challenged vaccines on babies, etc.”

    It’s interesting that people from Hungary, Poland, Checkoslovakia, etc. see right through all this BS while so many intelligent citizens do not see the long term implications and the forfeiture of their liberties occurring before their eyes.

  6. Rob March 26th, 2010 6:56 am


    If Doc Madden retires, come up to glorious Healdsburg, CA sip some wine and meet with my doc, Dr. Steven Vargas who operates just like Madden, cash with detailed receipt.

  7. Jeff Brown April 3rd, 2010 8:27 am

    The ultimate health care bill? The one where those currently in power begin to panic as good doctors either take cash only or retire — then attempt to make it illegal to do both. You smirk? It’ll happen.