Chiropractors want lawmakers to manipulate reimbursement rates
By JIM WATERS
Bluegrass Institute for Public Policy Solutions
Thursday, March 22, 2012, 4 p.m. – Special interest groups are camped out in Frankfort these days seeking special treatment from those charged to act in the best interest of all Kentuckians – not just a few.
Nowhere is this more a problem than in health-care related services where federal mandates and unsound policies have distorted the health-insurance marketplace to the point that any semblance of free-market activity is hardly recognizable.
It seems that interjecting free market principles that expand choices, improve quality and diminish costs would be the policy equivalent of unscrambling Humpty Dumpty’s egg.
For more than five years, Kentucky chiropractors have lobbied lawmakers to mandate higher reimbursement fees. This year, they put on a full-court press for House Bill 202 that requires insurers to reimburse chiropractors at rates no lower than those found in the Workers’ Compensation Fee Schedule.
Frustrated by reimbursement rates that have become tighter than a newly tuned guitar string, chiropractors want lawmakers to get involved and force insurance agencies to ante up.
I actually sympathize with the chiropractors.
They are getting it from every direction. They often get the shaft from others in the medical community when chiropractic patients get rid of their pain without expensive drugs and surgery. To add insult to injury, these professionals frequently get lower reimbursement rates from insurers than other providers receive.
After my comments in a recent Bluegrass Institute news release opposing mandated rates, the emails rolled in from unhappy chiropractors.
“We have been treated very poorly and criminally by the insurance companies,” said Winchester’s Perry Williams. “They won’t play fair… We have been cut 38 percent over the past five years. I get checks for 76 cents from insurance companies while the patient pays $25 to $35 for the service.”
Many chiropractors lament that their problems with insurers have worsened over the past several years and they want legislative relief.
While there are mandates for reimbursement fees tied to the federal Medicaid and Medicare programs, several policymakers have confirmed that passage of HB 202 would result in our state government doing for chiropractors what it has done for no other health-care provider: ensuring – by statute – they are paid a certain fee.
As a lifetime fan and patient of chiropractic care, I fully support chiropractors manipulating my spine to relieve the pain of pinched nerves and providing one of the best methods of injury treatment and preventive care available.
However, I cannot support the manipulation of state statutes to ensure reimbursement rates – for any group.
This has nothing to do with whether chiropractors deserve a higher reimbursement rate. They do.
The problem is, as I stated in my response to one of those emails from a concerned chiropractor: “I just don’t think government should be used to establish reimbursement rates for one particular health-care sector.”
To which my chiropractor friend emailed claiming to “understand” my point, but wistfully stated that “government should be able to step in where is a need.”
Actually, one of our greatest “needs” is for less government interference and more competition among health insurers, some of which may finally wise up and realize – it’s at least as good of a business decision to reimburse chiropractors a relatively small amount as it is to cut checks for surgeries that cost big money.
But ultimately, that’s the decision of insurers, not governments.
— Jim Waters is president of the Bluegrass Institute, Kentucky’s free-market think tank. Reach him at jwaters@freedomkentucky.com. Read previously published columns at www.freedomkentucky.org/bluegrassbeacon.
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