Guest Post: Obamacare Side Effect – Doctors Abandon The Health Care Insurance System Altogether

Tyler Durden's picture

Submitted by Pater Tenebrarum of Acting-Man blog,

Free Market Alert!

Many medical practitioners have apparently simply had enough. Instead of continuing their never-ending struggle with the welfare state's red tape, they have decided to revert to a free market model without insurance. At first glance that seems to represent a barrier to obtaining medical care for poorer strata of the population. However, a second glance reveals that this might actually not be the case. No doubt to the great dismay of the sick-care cartel and the bureaucracy administering it, the refreshing breeze of the free market suddenly intruding upon the system shows what prices actually would be if the State were not involved in health care. According to a recent report on the spreading 'cash only' medical care phenomenon:

“Fed up with declining payments and rising red tape, a small but growing number of doctors are opting out of the insurance system completely. They’re expecting patients to pony up with cash. Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.


In Wichita, Kansas, 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. (“Cash-only” is a loose description. Nunamaker accepts payment by debit or credit card too.)




Under the traditional health insurance system, a large staff was required just to navigate all the paperwork, he said. That resulted in high overhead, forcing doctors like Nunamaker to take on more patients to cover costs. Plus, the amount insurance companies were willing to pay for procedures was declining, leading to a vicious cycle. “The paperwork, the hassles, it just got to be overwhelming,” Nunamaker said. “We knew that we had to find a better way to practice.”


So Nunamaker and his partner set up a membership-based practice called Atlas M.D. — a nod to free-market champion Ayn Rand’s book Atlas Shrugged. Under the membership plan — also known as “concierge” medicine — each patient pays a flat monthly fee to have unlimited access to the doctors and any service they can provide in the office, such as EKGs or stitches.


The fee varies depending on age. For kids, it’s $10 a month. For adults up to age 44, it’s $50 a month. Senior citizens pay $100.


The office has negotiated deals for services outside the office. By cutting out the middleman, Nunamaker said he can get a cholesterol test done for $3, versus the $90 the lab company he works with once billed to insurance carriers. An MRI can be had for $400, compared to a typical billed rate of $2,000 or more.




Kevin Petersen, a Las Vegas-based general surgeon, stopped taking insurance in 2005. Petersen named the same reasons as Nunamaker: too much paperwork and overhead, declining payments from insurance companies, and a general loss of control. “The insurance industry took over my practice,” he said. “They were telling me what procedures I could do, who I could treat — I basically became their employee.”


Now Petersen does hernia operations for $5,000 a pop, which includes anesthesia, operating room time and follow-up visits. He negotiates special rates for the anesthesiologist and the operating room, and is able to provide the service for about a third of what a patient might pay otherwise.


Many of his patients are early retirees who are not yet eligible for Medicare but can’t afford a full-fledged health insurance plan, he said, and business is booming. “My practice at this point is the best it’s been in my 26-year career,” he said. “By far.”


While the cash-only model may please doctors, some question whether it’s good for middle- and low-income people. Kathleen Stoll, director of health policy at the consumer advocacy group Families U.S.A., didn’t want to speak directly to either Petersen’s or Nunamaker’s practice, as she didn’t know the specifics of each.


But in general, she fears that doctors who switch to a cash-only model will drive away the patients who can’t afford a monthly membership fee or thousands of dollars for an operation. “They cherry-pick among their patient population to serve only the wealthier ones,” Stoll said. “It certainly creates a barrier to care.”

(emphasis added)

Obviously, both the named and unnamed 'health advocates' and worriers have it completely wrong. People who don't have to pay thousands of dollars for health insurance actually can afford 'thousands of dollars for an operation' that costs only one third of what it would otherwise cost. It is not only the wealthy who can afford this free market care (besides, people who don't want it have the option to continue with the existing system).

Look at those prices! A cholesterol test for “$3 instead of $90” – that is more than 96% less! An MRI for $400 instead of “$2,000 or more” (usually will be 'or more')? Not to mention the fact that these doctors now have more time to actually care for their patients properly. What's not to like?


A Win-Win By Mistake?

Imagine for a moment what might happen if the government were to get out of healthcare altogether and there would be free competition between all health care service providers. What would happen to prices in that case? It is probably fair to assume that they would come down precipitously even from the low prices free market doctors are already able to obtain for their patients nowadays.

It is actually a good bet that the onerous red tape and the likely explosion in costs due to Obamacare will accelerate the move toward a free market in health care – unless the government explicitly forbids it, that is (unfortunately we cannot rule out completely that such tyrannical steps will eventually be taken – the government generally doesn't like it when its 'help' is refused). 

If so, the Obamacare Act could turn out to become a win-win by mistake so to speak, as more and more people decide to opt out of the system. It seems clear that the free market solution is preferable to the cartelized health care system imposed by government and the lobbyists that have co-written the laws. The doctors portrayed in the article above are leading by example, and we expect their ranks to swell in coming years.

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somecallmetimmah's picture

Free hellcare?!?  YEEEAAAAHHHHH, baby!  Sign me up for some of that!!!!

Groundhog Day's picture

doctors have forgotten that they have the power/  If they organize and set up these multi specialty practices, they can tell the insurance companies to go fuck themselves

unwashedmass's picture


my doctor already has. ditched the huge staff that shuffled paperwork. now direct want to file for insurance, great. he will provide you with the bill. that's it.


he's making 2x the money now. 

Groundhog Day's picture

the Insurance industry has scared the living piss out of people by telling them if you have a medical emergency you can go broke after you get the bills.  They are the ones that have driven up the damn cost so the execs can make millions a year.  I know so many good doctors that will see patients and help them out even if they don't have insurance.  The Amount they make ($40-50) from a patient who just gives cash goes further then the fight to collect from the insurance companies

Argos's picture

Ban the issuance of ALL types of insurance.  Think about it.  Personal responsibility would rule.  Without medical insurance, the costs of care would crater.  No person is paying $40,000 of a dose of a drug.  No more veggies living on ventilators.  No malpractice cases, no unneeded tests to protect from malpractice, no more $3,000 screws, etc. etc.

johnQpublic's picture

wife got a bee sting and went into anaphylactic shock

closest care was high peaks emergency care, a cash only institution as mentioned here

she damn near died

at that point money was no object

407 dollars

all in...not bad considering it cost me 3500 bucks for seven staples from a place where we were end

shit, we pay 300 bucks for an epi pen

and we got a whole lot more than that

all hail the free market

they are located just about a block north heading out of lake placid ny, if you are ever in the vicinity and need care

redpill's picture

This wouldn't be a problem if medical insurance was actually insurance, instead of a giant billing scam.  

Imagine a health insurance policy with a $10,000 annual deductible, and you can go to any doctor you want.  The premium would be low because the vast majority of people wouldn't exceed the deductible.  You could negotiate with the doctor on price because you're paying for it up to $10k.  Your doctor bills you, and you submit your paid invoice to your insurance company for credit against the deductible limit.  Then if something catastrophic happens, you don't go bankrupt.  THAT is insurance.  This $10 copay and $400 generic prescription crap is a joke.

Herd Redirection Committee's picture

I think I found Obama's theme song: Time, Forward!

Incubus's picture

Healthcare and Auto insurance, brought to you by the same dudes that brought you fractional banking.


Managing people is so easy, a caveman can do it.

HardAssets's picture

Yep . . . everyone is right about healthcare costs in a truly free market. People used to pay themselves and it was affordable. And their doc sometimes even made house calls. Then the various crooks set up their racket and the prices escalated.

Of course the new Commie 'care' aint about health care at all. Its about ripping off the American people.

Cyprus got 'bail ins' as a means to be robbed. They are using this bill to accomplish the same purpose.

Bust people financially & make them dependent and compliant.

Incubus's picture

Why should heatlhcare be mandatory?


I've been to a doctor once in the past 20 years.  When I went for a general checkup, he said I was young and healthy and to come back in a few years.


I can put away savings and pay for medical emergencies as I age.  I don't need a fucking nanny state fining me for the ignorance of others.  I eat properly (not what the food pyramid suggests) and I don't have any health issues.

Don't make me a virtual suggar daddy for those who lead lifestyles that drive them into sickness.  Learn about health/fitness and nutrition and many of your perceived problems will be addressed.  Get your head out of the matrix.

HardAssets's picture

Think of some of those things that are mandatory  - - - including 'education' for children & this new commie-care. Neither had much public support when first put in place, but the oligarchs put them in place anyway. These programs serve their narrow interests. Public education was about dumbing down the public to make them compliant workers in the factories and no future threat to the ruling 'elites'. It was a tool put in place since the 1890s-early 1900s. The healthcare bill is ultimately about draining away peoples money/independence and is a tool for control and population reduction. - - - If these statements seem incredible, read the book The Underground History of American Education by John Taylor Gatto. It can be read for free at

Downgraded's picture

Great point!  THIS is the biggie:  The malpractice suits!  It's partly "one of the reasons" health insurance premiums began to rise.  I remember it starting in 1970's.  Trial lawyers began this cottage industry of suing doctors.  Doctors began to be forced to practice "CYA medicine".  Got a headache?  Doc says, "Gotta have a CT scan".  This drove up costs fast!  Especially when technology grew.  (Not giving insurance companies a pass here...just saying it was a big part of the beginning of the end of cheap insurance and a no-problem healthcare system we had here in America.

Serenity Now's picture

I don't want to disparage doctors, but the MAIN reason for so many lawsuits is because doctors and hospitals make enormous amounts of mistakes that lead to patient deaths....something between 100,000 to 400,000 deaths per year.

That's PREVENTABLE mistakes.  

Now, if you want to argue that tort law (i.e., negligence claims) should go away, or that "assumption of risk" should apply to every aspect of life--from jumping out of an airplane to going to the doctor--then argue that.  

I don't want tort law to go away any more than I want criminal law to go away.  A crime is a criminal wrong committed against a person, for which the state will prosecute on behalf of the person.  A tort is a CIVIL wrong committed against a person, for which the person can sue for money to recover their damages (and yes, punish the wrongdoer). 

It's funny to me that the ONLY time we hear a cry for "tort reform," it's over healthcare.  It's a major Republican talking point, and they are wrong.  In any case, there was a study done by one of the think tanks that concluded that medical malpractice suits are an extremely small percentage of overall  healthcare costs.  Insignificant.

Free markets will fix this.  Nothing else.

To the person I replied to:  this was not meant as a rant against you!  I just like facts and clarity.  :)

HardAssets's picture

The whole structure of medicine as practiced today needs to be examined. The allopathic medicine ('drug em or cut em open') model was given its legalized near monopoloy as the result of certain oligarch interests, in particular - Rockefeller based.  More than 250,000 Americans are killed by this system each year. The CDC and FDA (like so many other govt agencies) are in bed with the corporate interests they are supposed to regulate.

Within this system, if a doc is sued because his training taught him to prescribe a medicine that was inadequately tested so killed a patient . . . . does it make sense to blame the tort system, (bad as it is) ?  Or does it make sense to re-examine the whole medical structure and open it up to competition and the free choice of patients ?

And knowing the thinking of some of those oligarchs who first financed and promoted the near monopoly of allopathic medicine, we may wonder if it produces the results intended. It is likely that many more than 250,000 Americans will die as a result of the new system being implemented.

Freddie's picture

My doctor stopped taking Medicare.  I was in there for a check up.  I paid cash money.  An old lady was crying to the staff.   Shame.  She mentioned ObamaCare and said she said she thought he would never do that.  She actually said "Obama said he would take care of us."  Dumb old bag.  

I think she voted for Obama - she fkked herself. 

LOL! Go die.

WillyGroper's picture

Hey Freddie "MovieStarAvatar", GFY

There's still some people that take others at their word. 


"Dumb old bag. She fkked herself. LOL! Go die."

You could go first. Hope you're good with your maker on that one.

You're a pathetic impotent fucking puke.

BigDuke6's picture

Nice to see someone still has some fight on this site.

Whenever i pop in these days its a fucking big loved orgy of saps.

HardAssets's picture

Tell some people AARP is just an insurance rip off and that they favored O-care and they just don't believe it. Such naive forever-children. They just can't believe theyre are some crooks and evil muthers loose in the world.

ImpotentRage's picture

I might have some sympathy for them, if their ignorance was not ruining it for the rest of us.

Falling Down's picture

I hear the same refrain all over town, now (city in Upstate, NY). Old people who voted for these turds, and supported ObamasCare's passage, are bitching and moaning 'cuz the ins. co's are dumping them. Example: MVP Health is dumping retirees who are on Medicare, and telling them to go get their health coverage with a different company.

Boo hoo, statists, now go eat your soylent green.

buyingsterling's picture

If this trend spreads look for the statists to ban it. Bank on it.

Downgraded's picture

I sure wouldn't bet against what you're saying!

Dull Care's picture

The one benefit of our degeneration into leftist hell is that the people who thought it would be their salvation will get exactly what they deserve.

HardAssets's picture

I know what you mean. I know an elderly man who is an old hardcore Dem. He has a sickly wife and a mentally disabled daughter. He voted for O cause he's always voted Dem.  He and his family are going to be devastated by Fascist -'care'.

And in a few years you can bet theyll be rolling out mandatory vaccines and 'mental health evaluations'. The 'less productive' will be sold 'death with dignity'.  This is their Nazi wet dream.

Freddie's picture

My guess is eventually his mentally disabled daughter will be in front of a Obama death panel getting a no vote. 

tenpanhandle's picture

Or on the ballot in California getting a yes vote into congress.

HardAssets's picture

Yes, and the same for his elderly wife who has dementia from a stroke.


I have no sympathy for younger people who are dumbf*cks. But its sad for old people who are more trusting, and less capable of dealing with new information. They have a tough time with the idea that 'their country' and the 'leadership' isn't what they were always taught. I've told elderly relatives about AARP and they are only now seeing how they have been lied to and screwed over.    "You mean its really not an organization to help us old people ?"

Downgraded's picture

Horrible thing to say about an old woman.  You don't know her circumstances.  Have more respect for the elderly.  There is ONE reason the Dems always chant about "Seniors".  It's because they know they are vulnerable.  It's difficult to get old and feel more vulnerable.  You'll be there one day. 

tenpanhandle's picture

 There is ONE reason the Dems always chant about "Seniors".  It's because they know they have lost their wits.

toady's picture

My dr. is closing her office on 10/31. I suspect it's an ACA thing, although she's blaming the other Dr's leaving the practice. I've heard from family that two of their Dr's are closing by the end of the year

It's a conspiracy I tells ya!

DoChenRollingBearing's picture

Bearing Guy is going to look into cash-only doctors when he gets back from Peru.

A great day for freedom?

NOTaREALmerican's picture

Re: gets back from Peru

BTW, what is the health-care system setup in Peru?

Doña K's picture

We were there on a trip and my hubby needed stiches in his thumb the emergency room charged us $18 and my husband still has his thumb with no visible scars. We were so overwhelmed we send the doctor a gift.

Curently in RSA. A physical including blood tests was $82 in a private clinic 


Freddie's picture

Bless those folks at that facility.  Hopefully this is where we are headed but Obama will bring in third world witch doctors.  SEIU and ACORN will run our healthcare.

About 25+ years ago - I twisted my ankle at my job in their warehouse.  It was not that bad.  I went home and when I went to sleep it starting hurting like hell.  I drove myself to the hospital I was born in, run by the Catholic church.  This was at about 1:30 am.  They looked at it and gave me an extra strength Tylenol.  The bill was over $150.  $150 today and back then was big bucks.  I had health insurance but if I used it, it would be a workman's comp claim. Like a dope I said it was twisted from work.

Well, if you claim workman's comp - you are pretty much unemployable after that.  So I forked over $150 for a Tylenol.  Inflation adjusted that is probably $300 today.

johnQpublic's picture

25 years ago?

shit, that 150 is prolly 1500 now

Freddie's picture

What if I paid in gold or silver?   It was just post-Jimmuh Carter.

buyingsterling's picture

Two twats gave you thumbs down. I guess they couldn't read your post through Obama's pubic hair.

BigDuke6's picture

Freddie is right

its classic socialist fare - promise the plebs the world with free health then import the 3rd world to supply it.

the UK NHS has 1/3 foreign doctors

Yes they fuck up a lot and grab pubescent titties now and again but they are cheap, dilute doctors influence and don't complain.

the USA will have to get in line to soak them up.  africa has been mined dry of dodgy docs. ( SA excepted)

my advice is if you have spare cash send your kids to any old shit medical degree from anywhere in the world.  eg caribean , fucking even russia

they will get their foot in the door of most western countries then make a good living.

RafterManFMJ's picture

They cherry-pick among their patient population to serve only the wealthier ones,” Stoll said. “It certainly creates a barrier to care.

^shut up, cunt!

NotApplicable's picture

My guess is that this will only be true if the AMA (et al.) demands tribute from these private doctors in order not to shut them down completely.

The beast must be fed.

Winston Churchill's picture

Harley street consultants are only allowed to practice if they work 20 hrs per week for

the National Health service.

They all drive Rolls and yet charge 20% of the consult here for private patients.

A hospital stay at say the Wellington in London is about 1k pounds per night base.

A truly excellenct hospital appointed like a Ritz Carlton.

Get the lawyers, and legislators out of medicine, and allow true competition.

Its just plain wealth extraction here in the US.

Freddie's picture

How bad are the NHS hospitals?  I heard they are unionized and a pretty bad.  Someone compared them to field hospitals in the Crimean War.   I also heard that islamics in teh Uk get their own NEW and separate facilities.

Oh - ObamaCare is a jizya or a tax on non-muslims by muslims because muslims are exempt.  What does "exempt" mean? My guess is it is all FREE for them.

BigDuke6's picture

The NHS is full of muslim doctors.

USA is full of cheesepope doctors.

we should get them together.

lasvegaspersona's picture

The AMA is like AARP. It is bunch of insurance agents and a few docs from acedemia. Very few practicing physicians are members. It is self funding from selling insurance and gifts from long dead donors. A bunch of old commies and political hacks. The fuckers sold medicine down the river when they backed Obama.

The American Academy of Pediatrics is similar, very far left.

SilverIsKing's picture

When everyone goes off the health insurance grid and costs come down, Obama will take credit for making it happen. And he will be right.

DCFusor's picture

I admittedly live in bumfuck-nowhere, but this has been common around here for awhile.  Carillion bought out most private practices and started abusing their near-monopoly powers, the bettter docs quit.

Then, some of them formed a private practice that has all the properties described above - and more.  For one thing, they do a better job with preventative care up front.  For another, they not only work for cash, but for barter in some cases.  Most of them are near-retired, and don't come to the office unless there's a particular need for their speciality, so the office is "manned" by a couple of women, one the primary care doc herself, who sets up deals with any of the specialists as needed - not so often, as she's pretty darn good herself.

And, they'll even work for barter, not just cash.  They were going along great, but this electronic health care records mandate is crushing.  Since I'm a computer guy, I might just set up healthcare for life by setting that all up for them.  The thing is, would O'care actually regard this as legit, and give me an out from that horrible mess?

Will they let the self-insured (me, everytime I've needed care, I've not been covered, and I always pay myself, I'm not a deadbeat) off?

Or, as seems obvious, is the conflation by big-insurance health insurance with "access to medical care" the real point of all this crap?  They've never provided me with even one tiny bit of healthcare (or sick-care), ever, yet I've had some care over a rather long lifetime.


There's gotta be some "out" here.  I can't afford O'care, and I don't spend anywhere near what it costs as is.  I chose to live healthy, and gut lucky in genes.  I don't want a subsidy, and in return, I don't want to give one to those fatties at walmart who CHOSE to be unhealthy.

Kobe Beef's picture

Yep. Health Insurance, Health Care, and Health are not the same things.

One is a racket, one can be handled by a free market, and one is your own personal responsibility.

midtowng's picture

Sounds like the real problem with health care isn't government - it's insurance companies.