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Long time readers of this blog will know that I am a strong proponent of direct-pay practitioners, of doctors who “drop out” of the system to establish medical practices in which they are paid directly by their patients. This kind of arrangement is the only way today for physicians and patients to enjoy the classic doctor-patient relationship; you know, the relationship where the patient agrees to confide completely in the physician, and the physician agrees to work solely for the benefit of the patient.
In the modern healthcare system, especially under Obamacare, this classic form of the doctor-patient relationship is not only frowned upon, but is considered unethical. It is unethical because doctors have formally adopted a “new ethics” which obligates them to work for “social justice,” which is a pleasant-sounding euphemism for covert bedside healthcare rationing. The direct-pay model allows physicians to avoid this odious new responsibility.
The entire healthcare system today is disposed to hate the direct-pay model. The reason typically given is that this model of practice will establish unfair “two-tiered” healthcare, the new, undesired tier, of course, being the one in which patients would enjoy the benefits of a professional advocate who is looking out for their individual needs.