In A Perfect World . . .

Matt Masewic opened Boscawen Family Practice two years ago with dreams and a plan. He had ideals about the kind of medicine he would practice. His independent practice would provide a service to the community - no rejecting patients without insurance, no 10-minute, rushed visits.

He also knew that finances would be tough. He brought in his brother to help him renovate the modest office he rented from the town, bought used equipment and furniture, and hired a bare-bones staff. He figured that this combination of frugality and quality medicine would help his practice survive.

But he was wrong. At the end of the month, Masewic will close his practice, leaving behind the rehabbed building and his roster of 1,200 patients, and holding about $500,000 of debt

Ideology is great, but it does not pay the bills.

Masewic's financial troubles have been even more acute than those of his peers, because he decided early on that he would not turn any patients away. He takes patients with private health insurance, but also patients with Medicare and Medicaid, which often pay him less than his cost for the visit. An Army Reserve veteran, he even takes military insurance, which pays so poorly that the next nearest provider is in Manchester.

Perhaps worst of all, he takes patients with no insurance at all and doesn't require them to pay him up front.

"I didn't think it would be so difficult to collect," he said. "I thought if I provided a good service, they'd pay for it."

'Fraid not.

Sadly, too many abuse the system AND your good heart.

Free is never appreciated.