Shock, anger, frustration, depression, bitterness, hope, determination. A short summary of the emotional roller coaster of the past 10 years at my small group practice. Like all of you, we are down-to-Earth people who happen to be really smart, who have worked very hard, and invested much of ourselves to become doctors in the service of others. At my clinic we do everyday medicine, not the kinds of things people will fly around the world for and pay cash. Our community and targeted population are middle class folks who simply must rely on private health insurance to pay for their health care.
Those have been our emotions after each pitiful insurance check, each denial on provider type, and every claw back for retrospective denial on provider type. Why are they doing this? How can the insurance companies be allowed to do this? Is there something wrong with us that we deserve this treatment?
Naturopathic Doctors have been licensed in Oregon since 1927. We have an excellent safety record and offer people a genuinely alternative approach to recovering their health versus managing their symptoms with pharmaceuticals. Our value is real, it is high. The insurance companies have marginalized our profession because up to right now, no one has effectively stood up to stop them. They have a market power over the purchases of their huge subscriber bases that we have no ability to balance economically. One by one they offer us "take it or leave it" contracts, no negotiations. They can afford to lose however many of us who say no, because there will always be enough of us who say yes.
This situation is made even worse by a disparity in the antitrust laws. Insurers are legally allowed to share information and collaborate on the "business of insurance." We are not allowed to do the same in return. If we organize an insurance boycott, share our personal fee schedules, attempt to bargain collectively, we are breaking the law and the insurers can make legal claims against us for violating antitrust. Insurers can tell each other what they are paying for various services, including to NDs. They are then allowed to use that shared information in creating plans and setting their subscriber rates. On the face of it, "prima facie" in legal terms, it appears they have also been telling each other they do not need to treat NDs fairly. That they can keep us on their hook economically marginalized without any risk of penalty to them.
This has been difficult for us to shed a steady light upon to reveal. An essential first step if we are ever to hold them accountable for this anti-competitive behavior. Their motivations are no doubt many; including bias against NDs. Simple greed, and a long history of behaving this way without repercussions are the most compelling reasons for why this discriminatory behavior continues in 2018.
Using a metaphor from a story from long ago, we have been standing before Goliath all this time with no stone for our sling. Helpless, in fact. Its taken time, involvement in regulatory committees, service to our state, and attendance of a lot of meetings. But now a stone has been found, we think a rather sharp stone. We are readying our sling and girding ourselves to face Goliath in the valley of Salem.
The report we have just completed based on a query of Oregon's "All Payer, All Claims" database is that stone. Our efforts with regulators and legislators will be our sling.
We are planning now to take up our new stone and our sling, and head into a match with a monster much much larger, much more fearsome looking than us. This contest is soon to begin, the outcome is not certain. We now have a weapon, and that is an enormous improvement of our situation. Continuing on as before is intolerable. We must gather our courage. We must stand up and fight for equitable treatment, for what is right.
We may not be allowed to collectively bargain, but we are allowed to organize politically. That organization is the OANP. We need you. We need every ND in the state of Oregon to be a member. Your membership dues, your donations, your availability to meet personally with the legislators that represent you, are why we need you to stand with us. Together we will wind up that sling with this new sharp stone, take careful aim, and let it fly!
If not us who? If not now, when?
Want to get involved? Here's how!
- Renew your membership by clicking here!
- Donate to the OANP Legislative Action fund by clicking here!
- Update your address so that we know which NDs we have in what districts. This helps us as we're doing outreach to legislators. If you work and live in different districts, put that information on your profile!
- Reach out to your local representatives! Send them an email letting them know that you are a constituent, and you vote - let them know the issue that NDs have around pay parity. Ask them to meet you for coffee, they want to hear from you! Click here to find out who your representatives are.
- Get involved! If you are interested in helping on a committee or a task force, email firstname.lastname@example.org