My psychiatrist stopped taking any insurance in 2008. He is in high demand and a smart businessman and here where HMOs sort of got their start, he saw the writing on the wall early on. He now charges $350 an hour, so I book a 30-minute visit, which is all I can afford, and I only go when I have to. I cannot afford a therapist and him, which is a shame, but I have other people I support and it's just not in the cards.

My practice was largely a cash business, maybe 70/30 cash vs. insurance. I always accepted whatever the insurers paid, including medicare. I felt it was my duty, bu lots of docs don't share that view. Getting paid 25 bucks for an office visit won't really keep the doors open.