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Comment and Controversy

Insurers get away with fixed reimbursements, yet raise their own rates

June 2006 · Vol. 18, No. 6
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Dr. Robert L. Barbieri’s April editorial, “How many days does it take you to pay for your liability insurance?” is very timely. Our specialty is restricted in its ability to charge appropriately for services rendered, mostly because we foolishly continue to “contract” with insurers. These companies have no problem raising their own rates, but they make sure reimbursements to physicians remain fixed. The result: Our specialty’s reimbursements have actually declined over the years.

Do you receive higher payment for a delivery in 2006 than you did in 1999? I doubt it. We should be charging more than $5,000 for any delivery, and this amount needs to be adjusted with the cost of living. As for malpractice premiums, in the 1990s they were half their current cost, if not less—yet ObGyns’ reimbursement remains static.

We need to wake up and remove ourselves from the insurance loop. Here is my reasoning: When a patient contracts with an insurer for health care, that contract is between her and the insurance company. We do not need to agree to accept reimbursement from the insurer as payment in full—particularly when the rates are inappropriately low. Rather, the patient should make up the difference. After all, she is the one who receives the care. If my car is damaged, I am expected to pay the deductible and any other costs not covered by my insurer. That should be the norm in medicine, too.

Although the sky-high rates of liability insurance have caused me to limit my practice, I feel I must speak out so others can continue to work and enjoy their profession.

Joseph C. Ptasinski, MD
Algonquin, Ill

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