A Portland, Maine, physician announced on April 1 that he would cut the middle man and deal directly with his patients, no longer accepting insurance in any form.

"I’ve been able to cut my prices in half because my overhead will be so much less," Dr. Michael Ciampi told the Bangor Daily News. Before, Ciampi charged an existing patient $160 for an office visit addressing one or more complicated health problems. Now, he charges $75.


Ciampi lost a few hundred of his 2,000 patients who had insurance and didn't want to deal with the hassle of paperwork for reimbursement, but he expects to make up the loss by attracting the self-employed, the young and others without insurance or with prohibitively high deductibles.

Now that he no longer accepts any form of private or government-sponsored insurance, he posts prices on his website, payable at the end of the visit. Patients with an earache or strep throat could spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50.

"I’m freed up to do what I think is right for the patients," Ciampi said. That includes making house calls and negotiating lower prices for patients with financial difficulty.

Gordon Smith, a spokesman for the Maine Medical Association, wasn't so sure, expressing concern for patients who rely on Medicare and Medicaid.

But Ciampi believes more doctors are likely to follow suit and cut out insurance entirely, even opening “concierge practices” in which patients pay to keep a doctor on retainer.

“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”