Fox News Health Blog: Bad Medicine: Is Your Insurance Company Hazardous to Your Health?
by Fox News Health
Infuriated by a deteriorating economy and blatant abuse of American taxpayers, the public is taking a strong stand to prevent banking executives from getting away with fiscal robbery. What many have failed to realize is that another industry — the health insurance industry — is getting away with murder, perhaps literally, by putting their bottom lines above your welfare, and this time it could be hazardous to your health.
Across the health care community from doctors to pharmaceutical companies to hospital organizations, steps have been taken to implement ethical standards. Codes of conduct are hardly a new idea. Most are self-imposed by professional organizations or trade groups on their members, often in an effort to voluntarily level up their members’ general behavior, especially in the wake of legal or political scrutiny.
For example, the pharmaceutical industry substantially revised its code governing interactions with health care professionals after public and professional criticism. Managed care organizations, however, are the only remaining hold-outs that have not adopted a Code of Conduct, leaving them highly unsupervised. Sadly, the very companies Americans often think help pay their bills are undercutting the quality of American health care in their pursuit of a fatter bottom line.
The game works like this: Health insurers’ profits increase as outlays for patient costs decrease. One such way to keep patient costs down is by prescribing generic drugs over name-brand drugs. In a practice known as drug switching, patients are switched from more expensive, name-brand drugs to generics, even if the name-brand drug was working and the patient experienced no negative side effects.
Managed care companies go to great lengths to make sure the switch appears innocent — a doctor is trying to help a patient reduce his or her medical expenses, and therefore recommends the generic. However, behind the closed doors of invite-only dinners and receptions hosted by managed care organizations, many doctors are lured into drug switching programs that offer attractive fiscal incentives, and there is no mechanism in place to regulate these practices.
Doctors are paying the price as well. In a survey done by the Toledo Blade last year among Ohio doctors, ninety-five percent of respondents said insurers interfered with decisions about prescriptions, 91 percent with testing, 74 percent with referrals, and 69 percent with hospitalization decisions. Eighty-six percent said interference compromised patient care, 76 percent said it adversely affected their patients, and 65 percent said they were unable to successfully protest denials. Most shockingly, 14 percent believed interference from an insurer had contributed to the death or serious injury of a patient.
This prompted a response from our now President:
“I am deeply troubled by The Blade’s report of how insurance companies, not doctors and nurses, are making decisions about patient care,” said Senator Barack Obama in a statement to The Blade. “Medical decisions should be made based on what’s good for your health, not what’s good for an insurance company’s bottom line.”
As managed care organizations seek to maximize profits and survive the economic downturn, the public can likely expect increasing use of cost-driven practices. These aggressive tactics must stop, and a comprehensive Health Insurer Code of Conduct must be implemented by which managed care organizations agree to abide by ethical standards such as transparency, clinical autonomy and, most importantly, patient safety and welfare.
The best Rx for every American is access to quality health care and medicine. It’s time to ensure the health insurance industry puts your safety before profits.
For more information about the National Health Insurer Code of Conduct go to: www.insurepatientaccess.org.
Fox News Health Tips:
· Know your medicines. Talk to your doctor about your prescriptions. Are they generics or brand names? What are they supposed to do? Are there less-expensive options? What are the risks and benefits of taking the drug?
· Be on guard. If anyone wants to switch your prescription, ask why. Will the new drug interact with existing medications?
· Appeal. With your doctor’s help, use your health plan’s appeals process to seek coverage for your desired medication.
READ THE ORIGINAL ARTICLE
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All News Items
August 26, 2010 - The Lund Report: The Best Care Possible: You're Worth It
June 14, 2010 - American Medical News: 10 things health insurers must do to regain trust; The AMA, with endorsement from 68 state and medical specialty societies, outlines steps health plans must take to be credible in the eyes of physicians and patients.
February 27, 2010 - Providence Journal: The creepy third person in doctor’s exam room
November 28, 2009 - Newport News Daily Press: MDs under attack
November 04, 2009 - The Hill: A code of conduct for health insurers
October 27, 2009 - WCBU-FM 89.9 (Peoria, Ill.) radio news
October 26, 2009 - WEEK (NBC - Peoria, Ill.): Developing a doctor-patient relationship
October 12, 2009 - Las Vegas Business Press: Here's a prescription: A health insurers code of ethics
September 09, 2009 - Maryland State Medical Society Resolution 14-09
August 29, 2009 - The Island Packet: AMA code puts doctors, patients in charge of care
August 28, 2009 - Baltimore Times: Group calls on health insurers
August 27, 2009 - Baltimore Times: Nursing Maryland back to health
August 20, 2009 - Lincoln Journal-Star: Pharmacists forced to serve insurers rather than patients
August 19, 2009 - WSTM-NBC3: Prescription medication battle heats up in Central New York
August 17, 2009 - New York State Senator Jeffrey D. Klein blog: For Health or Profit? Klein Unveils Sickly Scorecard of Major HMOs
August 17, 2009 - New York Daily News: Prescription Prescription drug coverage marred by bureaucracy, survey says
August 13, 2009 - Leading African American Groups Call On Health Insurers to Dismiss Restrictive Practices
August 13, 2009 - San Diego Union-Tribune: Bureaucracy won't contain costs
August 01, 2009 - Huntington, W.V. Herald-Dispatch: Insurers put stress on the physician-patient relationship
July 21, 2009 - Chicago Tribune: They authorized back surgery but denied his $148,000 claim
July 17, 2009 - American Osteopathic Association calls for Development of Code of Conduct
July 12, 2009 - Houston Chronicle: Another kind of remedy for the sick; Code of conduct would protect patients
July 07, 2009 - Washington Post: Health Reform: Who Holds the Reins on Care?
July 06, 2009 - NATIONAL HEALTH INSURER CODE OF CONDUCT HITS 1000 SIGNATURES OF SUPPORT
June 30, 2009 - Atlanta Journal-Constitution: Code of conduct needed for health insurers, too
June 24, 2009 - Penn. Pharmacists Association: “A Patient Walks Up to the Counter …”
June 24, 2009 - Pittsburgh Post-Gazette: Broken bonds; The physician-patient relationship is being destroyed by the cost-driven decisions of health insurers
June 09, 2009 - Bellingham (Wash.) Herald: Time for a health insurance code of conduct
June 08, 2009 - Mississippi Business Journal: Transparency is the best medicine; Health Insurer Code of Conduct may improve the quality of care
June 03, 2009 - Frederick (Md.) News Post Op-Ed: Pharmacists pawns in health care's game of chess
June 01, 2009 - KUSI-TV interview with Dr. Jack Schim
May 25, 2009 - San Francisco Chronicle: Doctor pushes back against insurer scrutiny
May 08, 2009 - Fox News Health Blog: Bad Medicine: Is Your Insurance Company Hazardous to Your Health?
April 27, 2009 - Petition for Health Insurer Code of Conduct Garners Widespread National Support
April 20, 2009 - On-line petition launched in support of a national health insurer code of conduct
April 13, 2009 - Petition launched in support of a national health insurer code of conduct
April 09, 2009 - Westchester (N.Y.) Herald letters: Access to Quality Healthcare
April 01, 2009 - Los Angeles Society of Allergy, Asthma & Clinical Immunology Applauds the AMA for Developing Health Insurer Code of Conduct
March 24, 2009 - Arizona Republic: Patient care, not financial gain, must take priority
March 22, 2009 - Rochester (N.Y.) Democrat and Chronicle: Health insurers should agree to a code of conduct
March 20, 2009 - Buffalo News: Code of conduct would protect patients from insurers
March 10, 2009 - AfPA Launches Petition in Support of a National Health Insurer Code of Conduct
March 09, 2009 - Texas Medical Society: Health Insurance Code of Conduct Act of 2009; The Time Has Come
March 09, 2009 - American Medical News: MSSNY president: Insurer settlements highlight need for code of conduct
February 01, 2009 - Colorado Medicine: Health Insurer Code of Conduct?
January 24, 2009 - Fresno Bee: Doctors push code of conduct for insurers
December 10, 2008 - Lupus Agencies of New York State Applaud AMA's Resolution to Develop a "Code of Conduct" for Health Insurers
December 09, 2008 - New York State Rheumatology Society Position Paper: AMA Resolution 823
November 20, 2008 - National Minority Quality Forum Applauds AMA's Health Insurer Code of Conduct
November 14, 2008 - Alliance for Patient Access Applauds AMA's Health Insurer Code of Conduct
November 13, 2008 - Alliance for Better Medicine Calls on California Health Insurers to Adopt a "Code of Conduct"
November 13, 2008 - Los Angeles County Medical Association Reinforces AMA's Call for a Health Insurer Code of Conduct
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