I made a decision two years ago to not accept health insurance when I opened my private physical therapy practice. Even thinking of this initially was frightening; however deep in my heart the choice was already made. At the time, I was working in the outpatient therapy department of a local hospital, and with the current structure of insurance payment reimbursement we therapists were asked to treat two to three patients per hour. I had spent about twenty minutes with one particular patient, treating his elbow pain, and was wrapping up his session when he mentioned that his neck had been bothering him. Something clicked in my mind and I realized that the stubborn elbow pain he had been experiencing was largely due to a cervical spine dysfunction, and a very quick screen of his neck confirmed my suspicion. In the face of having a second patient long overdue exercising independently on a piece of equipment, a third patient lying on moist heat and electrical stimulation, and a fourth patient waiting in the lobby I said something that I swore I would never say to a patient; sorry I don’t have time. Fifteen more minutes would have saved this man another trip to therapy, more time off work, and another high copay. My heart sunk as I sent him out the door and invited my next patient in. I felt like my patients were on a conveyer belt and if I didn’t keep pace they started stacking up until the end of the day when I was buried in paperwork and left feeling very unsatisfied. I finished work every night exhausted and resentful; something had to change.
I took a chance and decided to spend a minimum of a full hour with every person so that we could address every facet of his or her problem. We would spend uninterrupted one on one time together for assessment, treatment, and abundant education. I decided to answer every question and give myself completely in both energy and attention. After working in the traditional insurance reimbursement system for eighteen years, the results of this new method were quite interesting. I noticed that I only needed to see patients once per week instead of three to achieve similar outcomes. Unfortunately this model is not sustainable when reimbursement is dependent on third party payers. Most insurance companies reimburse about $50-60 per patient. The interesting thing is that if the patient has a $40 copay then the insurance company only chips in $10-20 to make up the difference. So if a patient pays three copays a week to total $120, plus travel and time from work he is actually spending more out of pocket money than my $100 per hour private fee.
The big question really is, “Who’s health are health insurance companies ensuring?” With premiums rising annually and benefits being reduced regularly the answer becomes fairly obvious; their own. So what is the answer to this so-called health care crisis? I see this as the opportunity of the century, the chance to invest resources in our own health rather than an insurance company’s health. Health insurance companies have us convinced that we need them and of course with the statistics of heart disease, cancer, diabetes, and every other ailment known to man on the rise how can you blame them. Interesting though, experts suggest that 60-90% of all doctors’ visits in this county are directly related to stress imbalances. With our nation spending three trillion dollars per year on health related costs, this means around two million are easily preventable. There is no pill for an out of proportion stress response; only lifestyle practices that return our body’s physiology to healthy internal balance.
Our nations greatest employers like the automotive industry, state governments, and other large corporations are being crippled by health insurance costs forcing jobs to go overseas to places where health care apparently isn’t of great concern. Soon the dysfunctional juxtaposition of monumental insurance costs with massive unemployment will be realized unless someone comes up with a solution. For what its worth, here is mine. We can teach twenty people all that they need to know about how to manage their own stress in eight hours. This training would cost a company about $1,000. Now if that same twenty people had on average health insurance premiums of $6,000 per year apiece, equaling $120,000 total and 75% of that was preventable at $90,000 than we just saved that company $89,000. Not a bad return on investment. The coolest thing is that continuing treatment is FREE. That’s right, it won’t cost any one else a dime.
So now, all we have to do is convince these companies to take a chance just like I did. Tell the insurance companies no; tell them that the money budgeted for premiums will now go directly to programs that actually improve peoples health instead of waiting until they get sick and then providing them with substandard service. Imagine if a company with 100 employees, spending $500,000 per year on health insurance premiums were to take all of that money and spend it on stress management education, smoking cessation, yoga and tai chi classes, an organic, whole food cafeteria, and a Zen garden. Who wouldn’t love to work there? I can almost guarantee that this company would naturally become the most productive and profitable organization in the country. Is there anyone willing to try?
-Brian Trzaskos, IRQTC