Should insurance contracts come with black box warnings?
A colleague wrote:
If your practice is what you want it to be, then do not spoil it by taking (hundreds of) Medicare patients in order to fulfill the criteria for the stimulus money. Doctors have been giving up autonomy for money for years and that is why 58% would quit medicine if given the chance. If you feel your practice is financially faltering and you need an infusion of more patients or you particularly like elderly patients, then go for it. But do not let the beauty of the spinach entice you to taste the toxic stew unless you are starving and there is no other food around.
I know I accept insurance and therefore have been drinking the stew for years, but I realize how it zaps my strength and had initiated a cancerous growth that will almost certainly force me to stop practicing medicine early. Nearly every week I ponder the idea of breaking from the insurance industry. The reality is my practice would not financially survive. My patients don’t want to/can’t pay more than a simple co-pay. The federal stimulus will help my bottom line. Increasing primary care pay will help my bottom line. But, the stupid stupid stupid administrative stuff is what kills and that is what you accept when you sign on the dotted Medicare line. Insurance contracts should come with a skull and crossbones on the front page (open at your own risk). [emphasis added]
John
What an interesting idea. Since more and more primary care physicians are realizing that continued contracting with the insurance industry is forcing them into a downward spiral of more and more ‘productivity’ at the expense of their patients and professionalism, maybe we should be lobbying for black box warnings on contracts?
WARNING TO PHYSICIANS: Used as intended, this contract could lead to direct patient harm in the event we choose to deny needed care or delay care through endless paperwork. This harm may in some cases lead to premature death or permanent disability. Signing this contract could force your practice into financial penury and increases the risk of career burnout. Numerous studies have demonstrated that this risk is particularly high for primary care physicians. Physicians should seriously consider the ethical and professional implications of signing this contract.
WARNING TO PATIENTS: Signing this contract in no way obligates the insurer (us) to provide insurance coverage for the member (you), though it does obligate the member to provide monthly payment to the insurer. If the member becomes ill and needs significant help* (*’significant’ is a subjective term that will be interpreted solely by the insurer’s employed clerks) we reserve the right to continue to collect monthly premiums while denying services. Signing this contract means the member has waived forever the right to sue. If there is ever a disagreement, the member must use our designated and beholden stable of arbitration lawyers in a complete sham of legal justice.
Primum non nocere
