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Ensuring quality care important: Legislature needs to pass House Bill 853

By Dr. Ralph McKibbin

There is nothing I enjoy more as a health care provider than seeing a patient make tremendous progress with their health.

And as you might imagine, there is nothing more devastating than watching a patient’s health deteriorate when his or her treatment plan is turned upside down.

You may not have heard of the term “non-medical switching,” but it’s an insurer-driven practice that puts money before patients and can have detrimental effects for Pennsylvanians.

Commercial health insurance companies in Pennsylvania are free to abruptly remove coverage for medications that keep Pennsylvania patients healthy and stable, without consulting their physician.

Right now, Pennsylvania lawmakers can act to put patients at the forefront of their health care and say no to dollar motivated greed. House Bill 853 would protect stable Pennsylvania patients from experiencing these unfair switches in the middle of the plan year.

The effects of non-medical switching can be felt by everyday Pennsylvanians like you and me. In fact, most people who experience non-medical switching have very manageable conditions.

That is until they’re forced to switch their medication due to a contract dispute or a cost to their insurance company.

Suddenly, a once manageable disease can take a serious turn for the worse. When a service or medication is unexpectedly removed from a patient’s health plan, it can delay treatment by several days, sometimes even weeks.

In this case, patients often find themselves falling back into symptoms and progressing in their disease. To make the situation worse, delays in care can lead to increased trips to the emergency room or hospital, which are proven to be more costly to both the patient and the health care system.

Treatment plans are not universal. One size does not fit all. In many cases, a patient goes through several rounds of trial and error with their physician to find the right treatment that works for them. This is the basis of the doctor-patient relationship.

It’s my job — and the job of any physician — to build an effective treatment plan with my patient using the tools and resources I have at my disposal. In my daily work, non-medical switching makes it difficult to manage that treatment plan and serve patients to the best of my ability.

Unfortunately, current law prioritizes insurance companies as decision-makers and put profits before patients. It breaks my heart to see any patient face this reality.

Our state lawmakers have the opportunity to improve patient care and protect Pennsylvanians from non-medical switching. By working together, legislators can improve the quality of life for those across the state and protect health coverage for all Pennsylvanians.

I’ve been a practicing physician in central Pennsylvania and a patient advocate for over 30 years. Over the years, I’ve seen firsthand how certain insurance practices can negatively affect the people I serve and limit their ability to access quality care.

In order to put the well-being of Pennsylvania patients first, we must move toward a health care system that allows patients to remain stable on the medications they rely on.

It’s time to put an end to non-medical switching and empower providers so Pennsylvanians can receive the care they need and deserve.

I’m calling on the Pennsylvania Legislature to vote yes on House Bill 853 and stand with patients across the state.

Dr. Ralph McKibbin is a practicing gastroenterologist and immediate past president of the Pennsylvania Society of Gastroenterology (PSG).