Letter to private insurance.

In 1965, President Lyndon Johnson signed the Social Security Act Amendments into law creating Medicare and Medicaid with the promise that the federal government would not interfere in any way with the practice of medicine whatsoever including compensation, administration, or operation of any institution, agency, or person per Title XVII SEC.1801. Government has broken its promise not to interfere with the practice of medicine. Politicians, starting with the President of the United States, have lied to us to get laws passed that allow them to fundamentally transform the USA, and now, in spite of what they promised, if you like your plan, you CAN’T keep your plan, and  if you like your doctor, you CAN’T keep you doctor.

To ultimately achieve single-payer, government-run healthcare, government cut deals with big private health insurance corporations and mandated we buy government designed insurance products from these companies “or else.” These companies follow government marching orders lockstep in order to stay on the take.

While their mission statements say they care for us, the patients, truth is, big insurance companies care more about their bottom line, the profit, and they will do whatever it takes to enhance it. So, when government sold out to hospitals and IT and required physicians adopt the nonsensical, wasteful ICD-10, a World Health Organization based coding system, insurance followed suit. Alas, if physicians don’t do what government and insurance companies say, we can’t even bill patients for our services. We’re out of luck.

America’s physicians are trapped; we’re afraid of losing our patients, our autonomy and ability to practice medicine, and our livelihoods if we don’t implement and comply with big government/big insurance commands. Problem is, I’m not willing to sell my soul. I stand by my patients and the Hippocratic Oath.

Accordingly, on October 1st, I will be forced out of Medicare and private insurance because I will not adopt ICD-10. Though I have already severed ties with most insurance companies, I sent this letter to the remaining ones with whom I have an agreement. In typical fashion, I’ve heard nothing back. The insurance companies don’t even have the decency to respond. The doctors are clearly nothing in this perverse food chain. Where does that leave patients?

Big insurance is colluding with big government at the expense of patients and doctors. Please read my letter and understand why I will be unable to bill for services for any private insurance patient as of October first.July 28,2015.

I pray my patients will choose to stay in my care. I promise to care for you to the best of my ability with privacy and dignity, with transparent, low cost fees, and with the best, innovative, state of the art technology available in the world. While government and insurance compel and control you, I will care for you. Let’s stand together.

I wonder if I’ll ever even get a response to my letter.  If big insurance treats patients in this fashion, the consequences will be grave.

July 28, 2015
Dear Private Health Insurance Company (Blue Cross/Blue Shield, Cigna, and Humana),

Many of my patients purchase medical insurance from your company. My steadfast commitment is to my patients, the patient-physician relationship, and the Hippocratic oath. I will continue to serve my patients to the best of my ability undeterred by third party interference in the patient-physician relationship, and I will only comply with and implement policies or procedures that 1.) serve the patient first and 2.) are the best utilization of precious medical resources, including time and money.

On October 1, 2015, ICD-10 codes are required to bill CMS for services provided to Medicare patients. I am not implementing ICD-10, because doing so does not serve the patient first and is not the best utilization of resources. Your health insurance company is a private company, not a CMS entity, but apparently, many private insurers are voluntarily converting to ICD-10 lockstep with CMS.

I will continue to see my patients in spite of my non-adoption of ICD10, because the preeminent, inviolable relationship that must be preserved exists between patient and doctor. The insurance company-customer and government-subject relationships are secondary by orders of great magnitude. Patient care trumps company coding.

Nothing in my agreement with your company compels me to do what is not in my patients’ best interests and is not the best utilization of resources.

A significant proportion of physicians across the US agree with me. How are you planning to pay for your customers’ services when their physicians do not use ICD-10? Will you continue to use ICD-9 codes simultaneously? Will you use actual diagnoses in standard medical terminology using actual written words, such as, cataract right eye and corneal laceration left eye? Will you have your customer pay the physician directly and then reimburse them for the benefits they are paying you to provide? Will you refund or reduce your customers’ premiums, because you have implemented company policy with which their promised physicians cannot comply? Have you quantified the potential impact of physician ICD-10 non-conversion on your customers, America’s patients? What is it you sell, if you have no doctors?

Your customers pay you to facilitate their access to medical care, not to prohibit them from seeing their doctors. I want to know what you plan to do on October 1st when I provide services to my patients of 20 plus years who happen to have been your customers for perhaps a fiscal year or two, and I do not provide you with an ICD-10 code.

This is just sixty days away. Stonewalling is not an option. I await your timely response.


Kristin S. Held, M.D.


5 thoughts on “Letter to private insurance.

  1. Kris, as you know I applaud your efforts, and agree with the stand you are taking. The problem is the insurance companies and the government are not listening. Until a significant number of our colleague follow us, nothing will change. It boils down to each physician deciding for himself or herself which path to accept: corporate servitude or freedom to serve. That’s a choice that most physicians have never even considered because they’ve been trained to follow the rules rather than their hearts.

  2. Interesting piece , I’m working on understanding the implicit nuances . Is there a sub rosa agenda ?

    Sent from my iPhone


  3. Dr. Held is exactly right. There are no hidden agendas. The doctor patient relationship is being destroyed by 3rd parties. The patient must be placed in control-financially and otherwise of his or her own care.
    We as doctors must make our voices heard.

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