Restoring Independent Medicine
A path to lower costs, better care, and a more resilient healthcare system
Dr. Robert W. Malone
2 hours ago << EDITOR ADDED DATE 2026-10-24>>
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Health Policy & Reform / By: Dr.s Jill Glasspool Malone and Robert W. Malone
American medicine does not have to remain trapped between government bureaucracy and corporate control. There is another model, rooted in the traditional American principles of independent businesses, professional responsibility, competition, and individual choice. For generations, physicians operated their own practices, established relationships with patients, and made clinical decisions without consulting corporate administrators or insurance-company utilization-review departments. They were medical professionals and small-business owners, responsible for their employees, expenses, and the financial survival of their practices.
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Another existing federal program offers an interesting precedent. The National Health Service Corps provides educational loan repayment for eligible physicians and other clinicians who agree to serve in designated shortage areas. Qualifying primary care clinicians can receive up to $75,000 in educational loan repayment for a two-year service commitment. The federal government has therefore already accepted the principle that reducing medical-school debt can encourage physicians to enter certain types of practice.
Why not apply a similar principle to restoring independent medicine? The objective should be to encourage independent practice across America, not merely in government-designated shortage areas or among physicians willing to accept another set of bureaucratic conditions. Assistance could be available to qualified physicians regardless of specialty or geographic location, whether establishing their first practice, purchasing an existing one, or leaving corporate employment. Eligibility should focus on professional credentials, independent ownership, and financial viability rather than government-imposed requirements governing patient populations, fees, or business operations. The purpose is to remove obstacles to independence, not replace corporate administrators with government administrators.
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Medicare and private insurers may pay more when care is delivered through a hospital outpatient department than when substantially similar care is provided in an independent office.
This is precisely the kind of government-created economic distortion that fiscal conservatives should question. If two qualified physicians provide the same service to comparable patients, why should ownership by a hospital corporation justify a higher payment? Site-neutral payment reform, where clinically appropriate, could reduce incentives for consolidation while preserving reimbursement for services that genuinely require hospital-level resources.
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As usual, when we push over the “rock” (of high prices), we find “nest” of parasites and diktats that raise costs and create all sorts of market places distortions.
I remember how simple it was for my Mom to get me an appendix operation. She got the estimate and while I was under the knife she crowdsourced the money from her savings and relatives. Paid the bill; thus bailing me out. Everyone involved inspected the bill and found some items to be renegotiated. Submitted the bill to her employer sponsored insurance company. About a week later, she got a check from the insurance company, cashed it, and paid off the crowd sourced debts. Put the reminder back in her savings account. I remember the operation cost her 105$!
A much much better system.
Like the tom woods sponsor “crowd health”.
A huge area for improvement in the current system.
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