Whether to Opt out of Medicare: How to Make a Titanic Decision (Viewpoint Essay‪)‬

I seriously considered opting out of Medicare over the Christmas holidays of December 2007, when a 10.5 percent Medicare cut was looming for January 2008. On Aug 1, 2008, I sent letters to my patients and referring doctors letting them know I was changing to a "self-pay" practice model. As of Oct 1, 2008, I opted out of Medicare, Medicaid, and all private-pay insurance. To my knowledge, I'm the first nephrologist in the United States to embrace this practice model.