Healthcare Reform Can Learn from Car Insurance

My first impulse when writing about Robert Hardi is to make him as apprehensive as he makes me. That's probably not possible.

I have been on the receiving end of half a dozen of the doctor's colonoscopies and upper endoscopies in the last decade.

The colonoscopies involved probing my intestinal tract with a miniature camera.

The upper endoscopies involved climbing down my throat with a different camera in search of stomach cancer.

And while pain has never been an issue, my heart beats like a rabbit when Hardi enters the "procedure" room.

Yet in my anxiousness, I sometimes wonder how much he earns from his invasive cameras.

It's a lot. But first, a little bit about Hardi, 62. I was surprised to learn that in addition to being a gastroenterologist specializing in diseases of the bowel and digestive tract, he is also an entrepreneur with a colorful past. He speaks four languages, fled Hungary in the summer of 1977 and was tried in absentia for dissent. He was given a two-year sentence.

Growing up in communist Hungary left him with a strong aversion to socialized medicine, a specter frequently invoked in the current health-care debate.

"It's not a pretty sight," he told me. "Just try to find a doctor in the afternoon. . . . I still take care of patients through e-mail all over the world because it is easier for them to find me than to get someone on the phone there."

Hardi and his wife, also from Hungary, made their way to Washington in the early 1980s, where he bought the practice of an aging physician on Wisconsin Avenue in Georgetown for $100,000. He borrowed a down payment and paid the rest off in five years. He later moved to an office near the former Columbia Hospital for Women, where he shared space with two internists for 10 years.

Patient by patient, Hardi built his practice. He networked at hospitals, gave speeches and tried to make himself visible.

He also had good timing: managed care and health insurance became an important priority as the baby-boomer population began to age. Also, there was growing medical support for the benefits of colonoscopies.

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