New York Times Examines Physician Payment Structures That Require Patients To Pay Fees for Access To Care
The New York Times on Sunday examined some physicians' adoption of a payment structure in which patients pay a monthly fee of $20 to $30 for access to their physicians' services, in addition to premiums, copayments and deductibles. Although this policy might seem "far-fetched," physicians in Washington, Illinois and Ohio already have adopted it, and health professionals say it will likely spread to other places, the Times reports. Adoption of the structure is being motivated in part by increased financial pressure on doctors, including increased medical malpractice insurance premiums, decreased Medicare reimbursements and increased administrative costs in conjunction with declining medical revenue. Physicians say that access fees will allow them to limit their practice size and let them provide more accessible care, including same-day and longer appointments.
Investigations, Reaction
The Washington state insurance commissioner's office is investigating the access fees' legality because of consumer complaints, and the Illinois Department of Insurance is discussing contractual issues with insurance companies, the Times reports. Mike Kreidler, the state insurance commissioner, said he thought added fees could be structured to not conflict with provider contracts. However, Arthur Caplan, chair of the Department of Medical Ethics at the University of Pennsylvania, said, "Paying a monthly fee for what ought to be part of what your regular bill covers is morally dubious" (Andrews, New York Times, 11/16).