If we needed more proof of the inadequacy of our system of health insurance, Post-Star reporter Kathleen Moore’s recent story on the costs of physical therapy provided it.
Providers told Moore that, in some cases, co-payments patients have to make exceed the cost of the treatment, so the providers end up sending out refunds.
Physical therapy often requires two or three sessions a week. If your co-pay is $40 or $50 – or even if it’s $20 or $25 — the monthly cost can quickly become more than you can bear. If you’re getting by on a modest income, paying an extra $200-$600 a month is not feasible.
What we end up with, as with so many things, is a short-term savings that leads to a much greater long-term expense. People who cut short their physical therapy, or don’t go at all, don’t recover from injuries and don’t heal. Problems never get better, or they get worse, requiring more serious intervention later, like surgery.
Physical therapy is preventative. Unfortunately, so much of what we do in health care is reactive and focused on the short-term, and that is true also in other areas of public policy like education and the environment.
This dynamic plays out starkly when our children are young, and educational intervention through programs like Head Start and therapeutic intervention through physical, occupational and speech therapies can make dramatic, life-changing differences. The benefits of these early interventions are large.
On a smaller scale, the same dynamic applies to physical therapy for adults, which is why we support the physical therapists who marched recently in Albany in support of state legislation that would limit copayments.
The bill would require insurance companies to stop inflating copayments by classifying physical therapists as “specialists,” which can push Medicare and other copayments as high as $50 a visit.
The New York Physical Therapy Association has a sample letter on its website (nypta.org) that you can use for writing a letter to state Sen. Betty Little or Assemblyman Dan Stec or whomever your state representative is. The bill to limit high copayments is No. 1666 in the Assembly, No. 2319 in the Senate, and we urge you to take a look and take the time to write, because it makes a difference.
We’d like to see even more dramatic action than this bill would impose to reduce the cost of physical therapy — by considering a week’s worth of sessions or even a full course of physical therapy as one visit subject to one copayment. But at least a recategorization of physical therapy, to bring it on par with a visit to a patient’s primary physician, is a start.
We’ve been focusing on cost and making the case that encouraging physical therapy by charging patients less will lead to savings in the long run, as people heal better and avoid more serious health problems.
But this issue has another aspect and that is quality of life. Chronic pain and partial disability drain the pleasure out of daily life. Pursuing happiness, which we hold up as an inalienable right, is a lot more doable when your body is feeling good. Helping people heal and recover from injuries goes a long way toward making our state a better place.