Indiana Health Insurance
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Indiana Insurance Company and Defensive Medicine

Your Indiana insurance company, such as Chambers Roper, can tell story after story about the cost of defensive medicine. Defensive medicine is the use of tests and diagnostics that are unnecessary for patient care, and useful for only protecting the doctor from malpractice suits.

Each Indiana insurance company has its own policy on covering lab work, tests, and procedures that are intended to diagnose any number of medical conditions. Usually, if a doctor orders the procedures, your Indiana insurance company covers the procedures as long as procedures are followed concerning pre-approval. The pre-approval process is not an evaluative situation that affects whether or not the insurance company thinks you need the medical procedure as much as it is a bookkeeping and funding situation to make sure payments are made as promised.

The problem with defensive medicine is when it is implemented to provide defense for the doctor rather than better diagnostics for the patient. This becomes a situation often bordering on fraud, in which your Indiana insurance company pays for medical services that have nothing to do with your actual care.

One study on the issue of defensive medicine was undertaken by the American Journal of Orthopedics. In this study, the findings revealed that a random selection of 2,000 orthopedic surgeons reported that 96% of them use defensive medicine. The defensive measures account for one fourth of all medical services rendered by these doctors.

The use of defensive medicine is currently playing a major role in the rising costs of American health care. When you consider that 20% of America’s gross domestic product comes from the health care industry, the fraud surrounding defensive medicine is a real problem. The director of the study, Dr. Manish Sethi, pointed out that the reduction of defensive medicine would greatly reduce the overall cost of health care. Every Indiana insurance company, and those in the other 48 states, supports the findings of Dr. Sethi, saying that the yearly rise in premiums would be reduced with the curtailment of defensive medicine.

Another defensive act that doctors use to protect themselves from liability is that of refusing to treat high risk patients. They also refuse to provide high risk procedures, afraid of the medical malpractice suits that may accompany less than optimum results of their efforts. Your Indiana insurance company strives to work with doctors to provide you with the best coverage possible, but when doctors spend 25% of their budget on unnecessary medical procedures, it drives up the cost of your insurance. It is estimated that, with orthopedic doctors alone spending 25% of their budget on this type of medical care, and with over 20,000 orthopedic surgeons in the country, the total among just the orthopedic community is in excess of $2 billion dollars a year. All of this represents excess expense to the medical community, with nothing to do with actual medical benefits to the patient.

The call to physicians from each Indiana insurance compnay is to base medical procedures on evidence, rather than liability.

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