Relative reimbursements obviously differ. In this area, those that do take medicare have set themselves a quota, as these patients are seen at a loss. I initially calculated that our total practice would lose $40,000 a year when we opted out. In fact, our income rose slightly. Asking the patient to pay $35 for an office visit beat what Medicare was paying, and without the games.


David Grauman MD
Department of Medicine
Commonwealth Health Center
Saipan, Northern Mariana Islands