Another Bout of Physician Payment Insanity

Most Americans do not know that the major reason for our out-of-control healthcare costs and poor care is that our government and private insurance have adopted a Soviet style, non-market, bureaucratic method of payments that have no relationship to reality. The American Medical Association (AMA) and all our specialty medical societies have been co-opted to be active participants as they compete to outdo each other for tidbits of financial gain. In essence our medical groups have deserted their members and the public. Those specialties that will have decreased payments in the latest cycle have unbelievably agreed to the process, but not the results. 
       The winners are the bureaucrats and middlemen that are robbing us blind. The solution is to allow those who wish to direct their own care have tax deferred robust health accounts so that individuals can pay cash for most care, as well as nationally available catastrophic insurance.  These accounts would be funded by employers and government deposits, assuring universal access.
        We trust the poor with food stamps, why not those Americans who want control of their own healthcare?

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Ken Fisher MD

Dr. Fisher graduated from Tufts University in 1962 majoring in chemical engineering, and with distinction from George Washington University School of Medicine in 1968 having been elected to the Alpha Omega Alpha honor medical society in 1967. He was a resident, and then chief resident in Internal Medicine at the Mount Sinai Hospital in New York City, and a fellow in Kidney Diseases at Yale University, finishing training in 1974. He was employed at a number of teaching medical centers throughout his career. He has been an insulin-requiring diabetic since 1963. Dr. Fisher has been the program director for two internal medicine residencies and two nephrology fellowships and has published several scientific papers on nephrology along with many articles and a chapter regarding health policy. Dr. Fisher was also a consultant nephrologist in Kalamazoo, Michigan and the Medical Director for the Free Clinic in Kalamazoo from 2007 till its closing in 2010. He is the author of In Defiance of Death: Exposing the Real Costs of End-of-Life Care, Praeger, Westport, Connecticut, 2008 ( ) , and The Ten Questions Walter Cronkite Would Have Asked About Health Care Reform, (2011) a free e-book available at: and in 2016, Understanding Healthcare: A Historical Perspective available at:

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3 Responses

  1. Gary Pearce MD says:

    The only real problem with a cash discount is that it basically illegal if you are a Medicare participating physician. My understanding is that Medicare has to be billed your lowest fee, so if an agent from Medicare catches you, you had better have a good explanation….like perhaps a downgraded code. I always worry when the cash discounted patients decide to come back and ask for a receipt…..which we print up as a superbill. Many offices now require any patients offered a cash discount to sign an agreement that states that patient will not submit charge on their own to any insurance company.

  2. Ken Luckay DO says:

    Well put. If we could only make it happen

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