Politics & Policy


Learning the lessons of health-care reform.

I have finally figured out how to apply the lessons of Obamacare to save my own sinking medical office from bankruptcy.

Under the president’s health-care law, the stated goal of which is to provide easy-to-use health insurance for everyone, you — the struggling-to-make-ends-meet patient — will see your skyrocketing mandated premiums used to pay not only for contraception, but also for the medical sequelae of a rude and obese McDonald’s customer who chooses to eat one bacon cheeseburger with fries after another. As your physician, I will be paid less and less for treating you even as insurance companies charge you more and more to cover the self-destructive among us. At the same time, Obamacare mandates will shrink your co-pays to the point where I will no longer be able to afford coffee for my nurses.

Don’t get me wrong. I don’t mean to appear selfish or unappreciative of your choosing my services; in fact, I am committed to taking care of you regardless of whether doing so still pays my bills. I will keep my office door open as long as I can afford to keep the lights on. As a private practitioner, I am a dying breed, and even as most of my contemporaries join the ranks of hospitals and clinics, I am pledged to continue to provide you with the kind of care you are used to receiving.

After considering the problem of solvency for months, I have finally come up with a stopgap solution, one patterned after Obamacare itself. Why shouldn’t I learn a lesson on how to survive from the very law that’s endangering my existance?

You see, all patients who come to my office provide me with an imprint of their credit card, just in case they owe me a balance payment and ask me to charge it. I have credit-card data on all my patients, from my poorest to my richest, from my nastiest character out of a Dickens novel to my kindest old-timer who wouldn’t hurt a fly.

Today I figured out a little system, designed to save the professional lives of doctors everywhere while providing a security blanket for patients everywhere. It could be another pilot project within Obamacare. It’s simple, really: I would like the permission of the president and Congress to charge my most self-destructive and my richest patients a small amount on their credit cards each month to cover my service for the uninsured and underinsured. If you are an abuser of my little office, if you yell at my office manager or slam the door on your way out, I want the president’s permission to charge you a little more, too.

If the president gives me his permission, I will be able to charge my poor, kind, and polite patients a little bit less. If the doctors’ prayer to the U.S. Supreme Court fails and the insurance mandate survives, at least with Doctorcare I will still be able to keep my doors open.

— Marc Siegel, M.D., is an internist practicing in New York City, the author of The Inner Pulse, and a Fox News medical contributor.


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