I Don't Take Insurance

In New York State, where I practice now, and in Maryland, where I was previously, acupuncture is often covered by insurers. Of course, coverage is in a state of chaos. Every plan covers acupuncture differently (I once laughed off the phone a rep who said they covered a whopping $200 in acupuncture care). And within a single provider, they have different plans that cover acupuncture differently. It is my belief that I would spend all my time focusing on insurance reimbursement as a sole proprietor rather than on the needs of my patients.

But that is not really why I have decided not to take insurance. I teach an online continuing education ethics class that has NCCAOM, FL, and CA approval. In writing that class, I cross compared the Hippocratic Oath against Sun Simiao's Golden Principle. I was truly amazed at how different our ethical oath (if you subscribe to the Golden Principle) is from the Hippocratic Oath. In regards to my decision not to accept insurance, it comes down to an ethical obligation by acupuncturists to know as much as humanly possible about our patients.

In order to make money playing the insurance game, you have to reduce time with patients to see more patients and receive more reimbursement. In that model, you spend less time with each patient and therefore know less about each person's unique circumstances. Numerous experiences have proven to me that the smallest comment by a patient opens up the path to healing and that it might take weeks of close contact before that comment is expressed. The more time I spend with each patient, the better I am to heal them. Thus, to play the insurance game means my patients receive less time with me, I miss the crucial details, and I therefore reduce my clinical effectiveness.

I know that not everyone is going to agree with me in this analysis. Especially since not taking insurance limits patients to higher socia-economic strata. But this is my rationale and I'm happily sticking to my decision. I don't believe it has hurt my pocketbook. And I feel that I have gotten away from the evil organizations that are corrupting our nation's healthcare system by purposefully denying claims. As an aside, if you haven't seen the movie, Sicko, you should definitely rent it and watch the first half about the construction of HMOs.