Opting Out of Medicare — Opposing Views

Katharine C. Otto, MD
Article Type: 
Summer 2002
Volume Number: 
Issue Number: 

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



No votes yet

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?