Dropping Medicare, A Revolutionary Step?

There’s little doubt that the frustration over looming Medicare physician payment cuts is starting to boil over. In recent months, we’ve reported on the surveys showing that more doctors will stop seeing new Medicare patients or cut back on services if steep cuts go into effect.

^{Photo credit: Flickr user Visit Hillsborough}

If you’ve been listening to our Policy & Practice Podcast–subscribe to it on iTunes or check out the latest installment — you’ve heard the irate comments from virtually every major medical society, angry that Congress has yet to replace the formula that calls for constant cuts to physician pay under Medicare.

Just the other day, I was reading my email and came across another example of how this Medicare payment limbo is affecting physicians. It was a letter from Dr. Leah McCormack, a solo dermatologist in Forest Hills, N.Y., and the president of the Medical Society of the State of New York. In the open letter, she announced her plans to terminate all of her contracts with Medicare and managed care companies as soon as possible. With the Fourth of July holiday approaching, she called this her “personal independence day.”

So what drove her decision? Not surprisingly, a big factor was the government’s failure to permanently fix the Medicare payment formula. She’s also sick and tired of the time she and her staff have to spend handling claim denials, pre-authorization requests, and working with pharmacy benefit managers.

In her letter, Dr. McCormack wrote that she doesn’t know how her patients will respond. “I’m taking this step into the unknown not knowing if my patients will leave my care in order to stay in their ‘plan,’” she wrote. “I can only hope that they value the services I give as much as they value other goods and services that they purchase, such as cable, internet service, restaurant meals, ball games and movie tickets.”

Dr. McCormack isn’t advocating that anyone follow her lead and she noted that many physicians aren’t in a position to walk away from insurance. But with Independence Day coming up, she wanted to share the rationale for her revolutionary decision.

Tell us how you feel about Dr. McCormack’s decision. Would you drop insurance, if you could?

— Mary Ellen Schneider (on Twitter @MaryEllenNY)