How can a responsible physician refuse Medicare? So-called concierge medicine is alive and well in Marin County, which has a generous supply of well-to-do citizens and a rather meager supply of excellent primary care physicians and consultants. Central to this concept of medical care, one that I believe borders on the unethical, is the refusal to accept insurance as full payment for medical services. My personal experiences include rejection of quite generous private insurance and subsequently Medicare by "providers" (hate that word!), as well as medical catastrophes in the past year that would have depleted our savings if we had not had good medical insurance. I remain baffled by those who believe that everyone should not have access to medical care insurance coverage.