The doctor-patient relationship is founded on trust and confidence. Injecting inappropriate financial incentives in the middle of that relationship – in the form of health insurance kickbacks or other incentives not related to patient care – is wrong.
Unfortunately, the big insurance companies got their way and defeated a pro-patient, pro-doctor bill in the Legislature that would have banned such medical kickbacks.
House Bill 1411, introduced by Rep. Rosemary Marshall, was the perfect prescription to cure a disturbing trend seen around the country: big health insurance companies using dollars and cents – instead of a doctor’s medical common sense – to reward certain treatment decisions.
In one particularly disturbing case, a major health insurer in Michigan provided a direct payment of $100 per prescription to doctors who prescribed a generic – whether that generic was medically indicated over the name brand or not.
There was not a word in the letter to doctors about ensuring that the prescriptions written are best for the patient. It simply told physicians to switch for cash.
It’s happening in Colorado, too. One Aurora doctor told Newsweek that, despite being near the top of his profession in his “quality of care” rating, he was told that he needed to change the way he treated his patients, including shortening visits or choosing an emergency room based on cost not necessarily medical quality.
That’s wrong. And as someone who has been advocating for patients with mental illness for years, it’s frightening.
Given the logic and the power of the argument made that that the doctor-patient relationship shouldn’t be threatened by non-medical financial kickbacks, many believed that this bill would quickly earn approval in the Legislature. In fact, it sailed through the House nearly unanimously.
But then the sleeping giant of the health insurance companies awoke. And, in the Senate, the bill quickly was placed on life support. Why? The big insurers started talking about the bill increasing health care costs, or having unintended consequences. Specious but regrettably effective.
The fact is that the bill had only one consequence: protecting doctors and patients from financial kickbacks. Without the legislation, it could be yet another year before Colorado physicians and patients get the protections they deserve.
When a patient receives a prescription, he or she wants to know that the only decision driving that treatment regimen is medicine, not money. That’s an especially sensitive topic in the mental health community, for whom the exact mix of drugs is critical.
If patients begin to wonder, or if physicians feel unduly pressured, the bonds of trust between doctors and their patients can be eroded. Merely the possible presence of such inappropriate financial incentives is damaging.
Colorado patients and doctors want to focus on quality medicine built on strong bonds of trust and confidence. Health insurance kickbacks are about anything but.
Lacey Berumen is executive director of NAMI Colorado, a statewide grassroots organization that works to give strength and hope to individuals with mental illness and their families.
EDITOR’S NOTE: This is an online-only column and has not been edited.
