A Thought on a Cash Practice

A most of you know, I ran a cash practice for over 45 years. It was not difficult in the beginning. I think the average chiropractic fee was $4.00 when I began practice and everyone had a cash practice, I began with a box on the wall, there was no insurance. After all how much less than 4 bucks could someone drop in the box. It worked so well for me and made so much sense that I kept it even when average fees went up and insurance came into popularity. I kept it because I liked it. But that is not the thrust of this essay. This is about cash practice regardless of the method and there are many. When insurance became popular many “box” practitioners abandoned it. I had a friend who did so and told me he was now making twice as much money and working half as hard, meaning his intention was seeing as many people as possible in orderto make a lot of money. He had a different intention than I did. (He died unexpectedly shortly thereafter even though he was younger and never got to enjoy the increased income that he was making). This article, again, is not about a box on the wall practice. It is about the idea of a cash practice especially now that most insurance programs are nothing more than government Ponzi schemes. We all know how they are working out. The biggest Ponzi scheme in history has been the Social Security System. The idea was that those putting into the system would see a return paid for by those coming after them. Sounded good and most people jumped/were forced into the system. I forget the name of the first lady who got in but she paid in next to nothing and got a great return, by living a good long time. We now know the problem with the system and how some candidates for president see a solution, others want to “keep kicking the can down the road”, others don’t want to even talk about it. This is not even about the problem of Social Security. It’s about the idea of insurance and the inherent wrongness of it. As a chiropractor I felt that being lumped in with non-chiropractic people was somehow unfair. They more than likely would be using their and my premiums for care that I did not need or want. Somehow the prospects of “insurance equality” made it more acceptable to some chiropractors. I guess that is how all insurance and now government entitlement programs are rationalized. We are all “entitled” to life, liberty and the pursuit of happiness and some see that as the guarantee of it. Even though some people may never use chiropractic care, not want it, they pay for the people who are smart enough to choose it. Is that fair? I don’t know what the answer is. I know it is not taking from those who don’t want and giving it to the wants is the answer. As our president elect has said, “no one wants to see people dying on the streets” but surely there is a better way of solving the problem than getting the government or the insurance companies involved. That’s what a cash practice is all about, getting those who are totally inept (the government) and those who are totally incapable (the insurance companies) out of the business of peoples health and well-being. The details of such a system needs to be left up to someone smarter than me.