Richard Amerling, M.D.
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I remember the days of black-and-white television. When color television sets became available, they were expensive and few could afford them. And few networks broadcast in color, since the audience was limited. At a certain point of supply and demand, sets became less expensive, and networks went all-in for color. The same phenomena occurred more recently with the move to high 
definition TV. And so it will go with private, high quality medical care.
Years ago I penned the Physicians’ Declaration of Independence, urging physicians laboring under increasingly abusive third party contracts to opt out, to allow them to return to the unfettered practice of medicine. Increasing numbers of physicians are opting out of Medicare, and few participate in Medicaid (full disclosure: as a nephrologist taking care of dialysis patients, I have not opted out of Medicare). Declining reimbursements and ever-greater paperwork and reporting requirements are driving this trend. To a certain extent, this is also happening in the private insurance sphere, and for the same reasons. But what really limits physician opt out is the relatively small numbers of patients who are “self-pay.” With the implementation of Obamacare, these numbers are set to explode. More
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