On behalf of the undersigned 19 physician representatives and the thousands of Connecticut physicians we collectively represent, we submit this response to the recent article published by the CT Mirror examining medical debt lawsuits filed by physicians and other non-hospital providers in Connecticut.
The patient stories highlighted are difficult and deserve attention. No physician wants to see a patient struggling financially, and no physician enters medicine with the intention of taking legal action against those they care for.
However, what is missing from the conversation is how we arrived at this point.
Over the past decade, health insurers have aggressively expanded the use of high-deductible health plans. These products were developed and promoted by the health insurance industry as a way to shift more upfront costs onto patients while maintaining premium revenue and improving profit margins. Patients are now required to pay thousands of dollars out of pocket before their insurance coverage meaningfully begins.
The result is a fundamental restructuring of how care is paid for. Physicians provide services, incur real costs, and then must seek payment directly from patients rather than insurers. In practical terms, high-deductible plans have turned physician offices into the bill collectors for costs that health insurers have chosen not to cover at the time care is delivered.
This dynamic interferes with the physician-patient relationship in a real way. Patients delay care because of cost concerns. Physicians and staff spend time navigating payment issues instead of focusing on care delivery. Trust is strained when outstanding payments become mixed with clinical care.
At the same time, physician practices are navigating significant economic pressures of their own. Physician offices are community-based businesses with rising overhead costs, including staffing, technology, compliance requirements, and some of the highest medical malpractice premiums in the country. Reimbursement from government programs further compounds the challenge.
Connecticut’s Medicaid rates consistently rank among the lowest in the region and often fall well below the cost of providing care. Medicare reimbursement presents similar challenges, with rates that have failed to keep pace with inflation and rising practice costs. Taken together, these pressures leave physician practices heavily reliant on commercial insurance payments to remain viable.
At the same time, large health insurers continue to report millions and billions in profits while increasingly promoting products that shift more financial responsibility onto patients and physicians. High-deductible plans allow health insurers to collect premiums upfront while deferring their responsibility to pay for care, shifting costs onto patients.
When unpaid balances accumulate, practices are left with limited options. The care has already been delivered. The costs have already been incurred. Sustaining access to care in the community requires that medical practices remain financially viable.
None of this minimizes the burden medical bills place on patients. Medical debt is real, and it is a serious problem that deserves thoughtful solutions. The answer, however, is not to place greater scrutiny on physicians who are operating within a system they did not design.
The solution lies in addressing the root cause. High-deductible health plans have shifted financial responsibility in ways that harm patients and interfere with care. Legislators should focus on regulating these plan designs, restoring meaningful coverage at the point of care, and placing responsibility for cost-sharing structures back on the health insurance industry, where it belongs. Physicians should be focused on treating patients, not acting as bill collectors for the health insurance industry.
If Connecticut is serious about reducing medical debt and protecting access to care, legislators must focus on regulating high-deductible health plans. Until this is addressed, the problem will persist, and both patients and physicians will continue to bear the consequences.
Mariam Hakim-Zargar, MD, President, Connecticut State Medical Society
Rahul Anand, MD, President, Connecticut Pain Society
Donna Aiudi, MD, President, Connecticut Dermatological Society
Michael Biondi, MD, President, Radiological Society of Connecticut
Erik Carlson, MD, President, Connecticut Orthopaedic Society
Cara DeBenedictis, MD, President, Connecticut Eye Society
Jonathan Earle MD, President, Connecticut Society of Pathologists
Todd Falcone, MD, President, Connecticut ENT Society
Royd Fukumoto, MD, President, Connecticut Chapter of the American College of Surgeons
Boris E. Goldman, MD, President, Connecticut Society of Plastic Surgeons
Lars Helgeson, MD, President, Connecticut State Society of Anesthesiologists
Dawn Holcombe, Executive Director, Connecticut Oncology Association
Edmund Kim, MD, President, Connecticut Academy of Family Physicians
Ray Lorenzoni, MD, President, Fairfield County Medical Association
Atique Azam Mirza, MD, President, Hartford County Medical Association
James Ouellette, MD, President, Eastern Connecticut Medical Association
Doug Smith, DO, President, Connecticut College of Emergency Physicians
Elsa Stone, MD, President, New Haven County Medical Association
Anthony Yoder, DO, HPPC co-chair, Connecticut Chapter, American College of Physicians