I know of no better story to best characterize the feelings of America's healthcare community today than to relate a true story from about 200 years ago.
The US Federal Government sent General Benjamin Lincoln to negotiate a peace treaty with the Creek Indians. The chief greeted the general and asked him to sit down next to him in the middle of a very long and narrow log. After sitting down, Lincoln was asked to move over. In a few moments, he was asked to move still further.
The request was repeated several more times until the general reached the end of the log.
Whereupon the chief said: "move further." The general, clearly annoyed by now, replied: "I can move no further."
"Just as it is with us," said the chief, "you moved us all the way back to the water and then you asked us to move further."
Like the Creek Indians, the physicians of Connecticut do not want to move any further.
In Connecticut, we asked ourselves four very important questions.
- Why do HMOs arbitrarily delay, deny, downcode and bundle physician claims? The answer is, of course, because they can.
- Why do HMOs ignore managed care reforms enacted by concerned legislatures all over the country? Because they can.
- Why do HMOs offer physicians one-sided, coercive and unfair contracts? Because they can.
- And why do HMOs overrule medical necessity decisions made by physicians who spend one-third of their lives in formal education? Because they can.
There is a time to communicate and negotiate, a time to legislate and regulate. We had tried them all. There is also a time to draw a line in the sand and fight, and that time had come for us. We had made good faith efforts to resolve our many differences with Connecticut insurers, but we learned that when you put a limit on what you will do, you have put a limit on what you can do. Silence gives consent.
Our state legislators had listened to the concerns of Connecticut physicians and patients and stood tall and passed managed care reform measures, just as in the other states. The purpose of the legislation was to hold HMOs accountable. That good work was helpful and appreciated, but it did not put an end to the abuses in our increasingly dysfunctional health care system, which is dangerously out of balance. You can pass a law or many laws, but what good are they if they are brazenly, purposely, and blatantly ignored?
So on February 14, 2001, the Connecticut State Medical Society filed class action lawsuits against the six largest health plans in Connecticut state court
