What should I do?

Starting September 22nd, the government will not be sending out Medicare payments for nine days. (Really.) No interest; no late fee; no nothing. Just no checks.

What do you think would happen if I just decided not to pay my office rent until the 10th of the month when it's due on the 1st? What if I didn't pay my electric or phone bill? Do you think the credit card company would bat an eye if I dropped them a note telling them my September payment was going to be nine days late and not to bother charging me extra? Do you think pigs can fly?

My landlord would be at my door daily; my phone and electric would probably be cut off after a week (a bit of exaggeration given my stellar credit rating) and the credit card companies would cheerfully ignore my protests that I had told them all about it ahead of time.

So it would appear that in the world of business, service stops when not paid for. I can do that.

Between September 22nd and October 1st, I will refuse to see Medicare patients in my office. If they need care urgently, they can go to the ER. I shall also tell them exactly why I am imposing a moratorium on caring for them. And if (when?) this happens again next year and the year after that, I'll just be that much closer to the brink of opting out of Medicare entirely.