After walking out of your doctor’s office with a prescription many believe it is the end of the process to determine the treatment a patient receives. These days, unfortunately, the doctor’s decision is only the beginning of that process. The aggressive push to cut health care costs can mean that given a choice between providing the best treatment and cutting expenditures, it is the patient’s health that loses out.
Increasingly those making these key decisions are not doctors, but accountants from insurance companies or the government. They second guess doctors’ advice, looking for cheaper options even when those options risk the patient’s health.
No matter where you fall in the current debate about health care, everyone should agree that a strong doctor-patient relationship is the key to effective, personalized health care.
A simple and important step to protect that relationship will be taken later this year by the American Medical Association when it votes on a Health Insurer Code of Conduct. Physicians and patients across Washington have an opportunity to support this important effort.
The code is a first step in addressing a growing problem. Private and government health insurance increasingly creates obstacles to care by putting limits on what medicines are covered. They create expensive and bureaucratic preauthorization procedures that limit access to effective medical procedures, diagnostics and approved therapies.
The Health Insurer Code of Conduct was first proposed by the New York Chapter of the AMA, and seeks to achieve three important goals.
First, it helps patients and physicians know which health insurance plans give doctors the power to make the final decisions about treating their patients. Although the AMA resolution would not have the force of law, insurance providers could voluntarily agree to follow its guidelines, giving insurers the opportunity to say clearly that they put patients first.
Second, monitoring compliance with the code would provide patients and physicians with information useful to understand where we can save money and what efforts are counterproductive. Choosing a health plan is difficult and there is little good data to help people find the best plan for them. This effort could add to consumer information, helping ensure they choose a plan that fits their pocketbook and their needs.
Finally, it would give doctors and patients recourse where insurance companies did not live up to the promises of the code. Sometimes restrictions on care are bureaucratic rather than formal, like requiring patients to fail on several medicines before receiving the treatment their doctor recommends. In some cases patients must fail on medicines not approved by the FDA before moving to more effective treatments. The code would highlight these types of limits on treatment.
Now there is something everyone can do to make the code a reality. Physicians, patients and others who care about increasing the transparency and effectiveness of care can visit www.insurepatientaccess.org and add their name to the online petition and read the code.
As a doctor, I understand the need to avoid unnecessary expenses and help the patients in my care receive the best treatments they can afford. A myopic focus, however, solely on cutting costs can sacrifice the very thing physicians strive to achieve – the health of their patient. A Health Insurer Code of Conduct is one step to return the proper focus of health care.
