Consumer Activism in the Health Care Field
Unless we put medical freedom into the Constitution, the time will come
when medicine will organize into an undercover dictatorship to restrict
the art of healing to one class of Men and deny equal privileges to
others; the Constitution of the Republic should make a Special
privilege for medical freedoms as well as religious freedom.”
— Benjamin Rush, M.D., Surgeon General of Geaorge Washington’s armies and signer of the Declaration of Independence
Watch this CaliforniaOneCareNow.org. video on Youtube to understand some of the pittfalls of our current health care system and some solutions proposed.
Check out the youtube trailer for Kiefer Sutherland’s The Healthcare Movie on the page of Physicians for a National Health Plan.
The article below was was written in 1998 as employers were switching from traditional insurance companies (where doctors and therapists were the experts in treatment and were able to make a decision for treatment and fees) to a model called Managed Care (where clinical decisions and whether a treatment was reimbursable was decided on by the employer, the staff of MDs hired by the Health Plan or Managed Care Plan and their attorneys). This page will be re-written soon with links to updated consumer information and a little less attitude!
Tired of the endless loop of 800 numbers and vague answers from your HMO or Managed Care Company? Are you aware that there are very few insurance companies left and that the good laws once in place to contain insurance companies do not apply to 95% of third party payers? Chances are that you don’t have insurance, you have some other kind of health care plan.
They may promise you 50 psychotherapy visits per year, but the pressure is on the provider to see you in a brief therapy format as long as it is not medically necessary to treat you. Middle profiteers say they are controlling health care costs, but they are only cutting service to you and fees to the end clinician and creating expenses and profits. This is health care, this is profiting by controlling how much treatment and what kind of treatment you may get, not based on science, but on business.!
Despite the refusal of insurance corporations to give therapists fee increases or fee increases that reflect real inflation rates and cost of doing business increases, most of my colleagues are holding on by a thread. It makes me wonder how I will be able to spot, diagnosis and treat the next potential school/movie theater/public crowd bomber if I am limited in sessions and what I can do for treatment. With therapist making so little, they have to work harder often late into the night doing nebulous paperwork to please “the system”, and paperwork which is not really relevant to helping people.
With no reimbursement rate increases for therapists, check out the 2011 CEO salaries for these execs!
David Cordani, Cigna Corp., $19.1 million
Total 2011 revenue:$22.0 billion
Stephen Hemsley, United Health Group, Inc., $13.4 million
Total 2011 revenue:$101.9 billion
Angela Braley, Wellpoint, $13.3 million
Total 2011 revenue:$60.7 billion
Patricia Hemingway Hall, Health Care Services Corp. (Blue Cross,
WellPoint, Anthem), $12.9 million
Total 2011 revenue:$49.0 billion
Mark Bertolini, Aetna Inc., $10.6 million
Total 2011 revenue:$33.8 billion
Michael McCallister, Humana Inc. (MHN), $7.3 million
Total 2011 revenue:$36.8 billion
Now, check out the salaries of investor owned managed health care companies which were published in the April 6, 1998. With the passage of time, you can bet these high dividends have increased. No “Golden Parachute” for your therapist!
Steven Wiggins / Oxford Health Plans $111.9 million
William McGuire / United Healthcare $51.2 million
David Snow / Oxford Health Plan $34.3 million
William Sullivan / Oxford Health Plan $28.3 million
Robert Smoler / Oxford Health Plan $24.1 million
Alan Hoops / PacifiCare Health Systems $18.5 million
Wayne Smith / Humana $14.4 million
Ronald Compton / Aetna $14.3 million
Leonard Schaeffer / Wellpoint Health Networks $14.2 million
James Stewart / Cigna $11.9 million
Brief Solution-Focused Therapies may good for many problems, but unless you need access to psychotherapy for something that is “medically necessary”, these third party payers probably won’t consider paying for more than a few sessions. So if you are having a self-esteem issue or marital problem or your child is acting out in school, but you or your child are not severely depressed or anxious, you may be out of luck. As science has shown (and you can read this stuff in Time and Newsweek), minor negative behaviors and cognitions leave lasting ill effects on heart, brain, immune system and interpersonal issues, despite a medicalization.
These Sate agencies might be of help:
The Medical Board of California – Complain about a doc, complain about an HMO or just check out this site.
The California Department of Managed Health Care in Sacramento is extremely helpful in settling disputes. HMOs and Managed Care companies, which are a different kind of business than traditional insurance companies, are scared of DMHC. You can download forms and make a complaint about your negative experience with a health plan. It is not easy to tell if a health plan (also known as “third party payor”) falls under the laws supposedly enforced by The Department of Managed Health Care or the Department of Insurance. Ask your plan who they answer to and if you cannot find out in 2 minutes, my advice is to fill out complaint forms for BOTH state agencies as that would be faster than waiting on the phone! Ironically, when I have called the state agencies are not sure, especially if the plan is one of the smaller ones
Insurance Committe, California Dept. of Corporations , Sacramento, CA 866-275-2677
You can write your state legislators, California Legislators or Federal Legislators.
You can write to your employer and union.
Tell your story to the press, on blogs or to a call in radio program
U.S. Department of Labor 200 Constitution Ave., N.W., Room N-5658 Washington, D.C. 20210
These healthcare advocacy groups may be of interest and may be able to help you:
Families USA, 1201 New York Avenue NW, Suite 1100, Washington, DC 20005, 202 628-3030, [email protected]
Californian’s for Health Security 1144 65th St. Oakland, CA 94609
The Better Business Bureau
Mad as Hell Doctors have some pretty interesting videos that explain what is wrong with the American Health Care system.
Physicians for National Health Program also has a common sense solution to our current dilemma.
National Council of Quality Assurance (NCQA) 2000 L St. NW Washington, DC 80031 202 955-3500 www.ncqa.org
Harold Eist, MD and Bryant Welch, JD, Ph.D
The Legal Center for Patient Protection 1155 Connecticut Ave., NW, Ste. 300 Washington, DC 20036
202 429-6530 fax 202 332-8710
Health Access – 1930 Wilshire Blvd., Suite 916, Los Angeles, A 90057, 213 413-3587 A coalition dedicate