The doctor patient confidentiality myth

Mental health doctor patient privilege is dead if you want to obtain insurance coverage. Whether it's medication for a psychiatric condition or reimbursement for testing, neither HIPAA nor its office of last recourse, the regional Offices of Civil Rights will protect a patient from the prying eyes of the endless health insurance clerks responsible for processing claims.

While we're all accustomed to signing away privacy rights as part of the forms we sign for medical services providers who are submitting claims on our behalf, the nature of mental health and the stigma attached to the same make the treachery of the practice of insurance companies seeking examination of provider results before processing a claim particularly dangerous.

Second guessing doctors to the point of asking how they reached their conclusions justifying prescribing a medication to an individual encourages those who have sought and received help NOT to take that next step and try a medication their provider believes might bring them a healthier life.

So why not use this approach for all the costs of defensive medicine? Why are insurers letting medical providers send consumers for every test under the sun without asking for this same justification process? It's easy, money.

Doctors save money by ordering any number of tests because it helps them reduce any allegation of malpractice. Insurers pay a fraction of the costs of these tests. But ongoing medication? No way, no how.

So what can we do? Probably we'll seek ways to bypass our insurance companies or we will not fill prescriptions for many of these drugs.

The next chapter in the game of cat and mouse with health insurers is the new economy of obtaining medical services OUTSIDE the insurance model. And what will this do to insurers? They'll raise their rates and advocate penalties for those who don't pay for their "coverage."

As we look into reform, let's start with undoing the costs of implementing and maintaining programs that have failed, like HIPAA. These employees are frivolous, the program does NOT protect consumers...period.