What is insurance anyway?

I have been thinking about CA non-stop since I listened to Lisa Rohleder speak this spring in Maine. Its a revolution about which there are so many things that I agree with, there is no possible way that I can keep myself from creating a clinic that uses the CA principles. I feel a little bit on fire with the thoughts of where this concept will go. Something Lisa said in the conference that caught my attention is that “insurance is not going to save us.” That statement caught my attention.

And this week I had an experience that puts me on fire in a slightly different way. A long term, delighted and delightful patient called and left a message on my machine that her insurance company would cover acupuncture in the following way: if I am a member of their insurance company, I have the privilege of offering their members a discount on my fees. The message she left rambled on a bit, speaking about how her medical doctor gets a check from this insurance company every month just by having her as a patient, whether she comes in or not. That sounded strange to me. I am guessing she spoke of the doctor's arrangement because she was worried about compensation for me, and wondering, like I do, what the benefit is to me to become a provider-member of this company. I thought the things she was saying about the compensation for her doc sounded a little strange, so I called the company. I also feel loyal to her and wanted to check out the situation just in case I was wrong. Of course they wouldn't discuss policies with me. They did describe the following arrangement, however.

If you join one of these companies (such as American Whole Health or Harvard Pilgrim) as a provider-member, you are required to offer a 25% discount on your services to people who are card-carrying participant-members. The return for the provider is claimed to be a patient base. Now, the one reason this might work is the supposition that everyone in the company patient data base will want acupuncture. I agree. Acupuncture works, and is so useful that in my experience 98 people out of 100 love it and want to have more. So as I sit here and think about that fact, I feel my ire dissipating somewhat. Except that we all know the reality. Another way of thinking about this type of policy is that it is simply an insult to the practitioners to whom it is offered. I am just astounded at these policies and the fact that they still exist.

What is insurance, really? Perhaps at one time the ideal was actually socialist. The whole group pays out over the long term for the sake of someone in the group who might need services in the short term. One of the problems is, who defines “the group?” At this point in our country, the group is defined as those who can and choose to pay for it. Of course, with CA type clinics, the group is still defined as those who can pay for services. However, CA stays away from the spiraling moral degradation of the rest of American economics (Just charge more. Don't the principles of yin and yang tell us that continual movement in one direction usually results in movement in another direction to compensate?) and has found some brilliant methods to manage the business such that the needs of the patient and the practitioner are taken care of. We plan, as CA enthusiasts, to create clinics that are recession-proof, insurance-independent, and stand-alone-useful to lots of people. With the collective creativity of acupuncture practitioners arising in the field, and with the collective wisdom on CAN, it will be interesting to watch where this movement goes.

Thanks for reading. Sandy from Maine.