To the Editor:

The article “From the Hospital Room to Bankruptcy Court” written by Kevin Sack highlights an overlooked problem in our health system - health care is unaffordable for many who are fortunate enough to have health insurance. Health insurers are shifting more and more costs onto consumers, making care inaccessible for the insured.

Physical therapists see the impact of the cost shift on a daily basis. The majority of health insurers now require consumers to pay up to $50 per visit as a “co-payment” for physical therapy services when the total reimbursement from the insurer to the provider is little more than the co-payment. In fact, physical therapists have experienced instances where the co-payment the patient pays is actually more than the amount the insurance company pays the provider. Essentially, consumers are self funding their physical therapy care even though they and their employer are paying thousands of dollars for health insurance.

Physical therapy is a service that frequently requires a series of treatments to be successful.
In order for physical therapy to be effective, and the literature shows that it is, physical therapy has to be provided at the right time and at the right intensity. A course of treatment with an intensity of therapy three times a week for three weeks (which is not uncommon) may cost the consumer $600. A cost many Americans cannot afford. As a result of the high co-pays, consumers are reducing the duration of therapy or foregoing care all together, running the risk of needing more intensive and costly care at a later date.

While co-pays are fact of life, they should not prevent consumers from receiving medically necessary health care services. Providing consumers with affordable access to health care will result in lower health care costs and better results. It’s that simple.

 

James Dunleavy PT, MS
President, New York Physical Therapy Association

Posted 12/17/09