Sunday, November 22, 2009
An insurers' code of conduct is vital
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Robert B. Hansen
Hansen works at the MD Center for Pain Management in Portsmouth. He is also the associate clinical professor of neurology at Virginia Commonwealth University/Medical School of Virginia.
With the passage of health care legislation from the Senate Finance Committee, the health care reform debate will now heat up even more.
As the battle now focuses on the specifics of health care legislation, I would urge that any health care reform must strengthen the doctor-patient relationship.
Too often the doctors' authority is questioned as to the best course of action for our patients. That questioning is often based on an insurance company's assessment of the cost of the treatment as opposed to what is truly in the best interest of the patient.
A greater portion of my work day than ever before involves seeking approval from insurance companies for the treatments I recommend for my patients.
For example, as a neurologist who specializes in chronic pain medicine, I must spend a considerable amount of time identifying what the possible treatments are for my patients to best manage their pain. One effective new treatment that is available is a specific form of morphine. Rather than taking four, five or sometimes six morphine pills a day, this new form allows for 24 hours of pain relief for some patients. This medication often provides better overall relief of pain for the individual and a more physiological approach to managing chronic pain. However, many insurance companies discourage me from prescribing it due to its higher cost.
I am not alone in this battle. Nearly every doctor practicing medicine today could tell you a similar story. That's one reason doctors are leaving the profession at alarming rates. A survey in October 2008 by Merritt Hawkins & Associates, a physician search and consulting firm, and the Physicians' Foundation, which represent doctors, showed that 10 percent of the 12,000 physicians surveyed planned to seek a job outside the health care profession in one to three years. This is at least partially due to the fact that the role of the physician is under attack.
A critical element of any health care reform is a National Health Insurer Code of Conduct. The code would ensure that patients get access to the best health care based on their doctors' evaluation and not the profit-driven motives of insurance companies.
The code would also reduce costs. Patients with chronic diseases, such as chronic pain, heart disease and diabetes, would receive the care recommended by their physicians upon early diagnosis without health insurance companies pressuring doctors to try other less expensive treatments first that frequently don't work.
I urge Congress to ensure a health insurers' code of conduct is a part of any comprehensive health care reform legislation. Such a code would strengthen the doctor-patient relationship and go a long way toward ensuring that patient care is central to any reform.
