California’s Physicians: Do They Know Who Their Customers Are?

No sooner had I wondered at the CMA’s short-sighted and self-destructive sponsorship of a bill that would reduce competition in health insurance, than I see that they are sponsoring yet another bill that will further degrade the physician-patient relationship.

A little background: Since 1994 it has been illegal in California for group health plans to reimburse their beneficiaries for covered medical expenses. Instead, they must pay providers directly. That is not the way insurance properly functions. For example, if I crash my car, I pay the repair shop that fixes it, and I submit a claim to my auto insurer who reimburses me. That way, the repair shop works for me, and the insurer is answerable to me, too.

(It does not have to be this way. I understand that there are some auto insurers who have preferred repair shops, which can submit claims to the insurer if I choose to go there for a repair, but the law does not force such a relationship. Insurers, drivers, and repair shops are free to sort out these arrangements as they prefer.)

Unfortunately, the CMA sponsors AB 2805, which would extend the restriction on patients paying providers to individually purchased health plans, too. Obviously, if the state forbids patients from paying providers for covered medical care, we are going to have a lot of trouble achieving consumer-driven health care. (Curiously, the CMA otherwise supports consumer-driven health care, advocating legislation to make HSAs tax-deductible in California.)

You work for the one who pays you. Physicians consistently claim that they want to work for patients, not health plans or the government. But how can this happen if they refuse to accept payment from patients?

Once again, the CMA has done a disservice to its profession, and to patients, as well.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

Scroll to Top