Letter Re: Insurance Companies Encourage Immunization Paternalism

  As a practicing physician, I would like to alert your readers to a new policy which we are beginning to see from our insurance companies.&nbsp; As these companies become increasingly paternalistic, it is important to keep abreast of just what they are requiring, especially since most of these policies are invisible from the subscribers’ viewpoint.&nbsp; What we are seeing specifically is a policy under which we (the physicians) are penalized if parents opt out of vaccines, check-ups or follow-up visits.&nbsp; </p>
<p>The key here is that if you opt to follow a vaccine or check-up schedule that differs from that which your insurance company recommends, they will decrease my reimbursement for the entire panel.&nbsp; This means that if you have Anthem insurance (for example) and decline your chicken pox shot, we are at risk of losing up to 1% of our reimbursement for every patient who has the same insurance.&nbsp; At my practice that is roughly 50% of my patients.&nbsp; That may not seem like a lot, but here it would amount to about $15,000.&nbsp; Multiply that by every vaccine which is declined.&nbsp; The result will be that if you opt to vary from the schedule your insurance company &quot;recommends,&quot; we would ask you to seek your care elsewhere.&nbsp; This is wonderful from the insurance company’s viewpoint because it <strong>makes us the bad guys</strong>.&nbsp; </p>
<p>Please review your policy for this kind of &quot;incentive.&quot;&nbsp; While I am very supportive of vaccination and check ups, I also feel that it is not my job to be an enforcer, but to be a partner and educator.&nbsp; It is these kinds of policies that are driving good folks out of the medical field. – Peds Doc in Virginia</p>