In the 1960s, insurance carriers began to request lawyers to demonstrate what they did for their insureds. The metric was time. How much time did you spend on each matter, each task. What used to be a management tool soon became a pricing tool. And for decades, we’ve been using hourly billing as the modality for determining legal costs. With technology advances, I predict that alternative billing (fixed fees, contingency, capped fees, etc.) will once again prevail.

But, wait a minute. The legal community is not the only one controlled by insurance companies. I went to a cardiologist. All I wanted was a stress test to confirm that I’m fine. No, no cardiologist (I called more than one) would give me a stress test without a previous consultation. O.K. I can’t beat the system. I made the appointment. The doctor agreed I should have a stress test and an electrocardiogram. Fine. Can I make one appointment to do both in the same visit? No. Why not? Insurance won’t pay for both when done on one visit.

Insurance companies should do what they’re supposed to do. Pay for that which is covered. Instead, they get in the way by forcing professionals to alter their procedures in order to get paid. Or is this a case of doctors bilking the system to obtain greater revenue?