Ivan J. Miller, Ph.D.
Licensed Clinical Psychologist
Flatirons Medical Arts Building
350 Broadway, Suite 210
Boulder, Colorado 80305
(303) 499-3888


Ivan J. Miller, Ph. D.
Health Care Reformer

Dr. Miller’s interest in health care reform started in 1994 as managed care began to control health care services. Early on he realized that managed care practices cut quality and accessibility of services as readily as they cut costs. The managed care structure required so much money to pay for its bureaucracy that it needed to cut valuable services and create barriers to treatment in order to be profitable.

Dr. Miller’s response was twofold. First, to protect the integrity of his practice, in 1994 he developed a managed-care-free practice and also established the Boulder Psychotherapists’ Guild, Inc. The Guild is a model for the ethical marketing of mental health care services. It offers consumers accurate information about the benefits of mental health services so that they can make informed choices about using those services. Instead of relying on insurance companies to make referrals, the Guild gives consumers information about individual psychotherapists so that they can find a therapist who met their needs. In 2006 the Guild has 78 members and has become a national model for ethical marketing.

Second, Dr. Miller addressed the larger issues of health care delivery. In 1994, he published a book about the negative impact of managed care on mental health services, “What Managed Care is Doing to Outpatient Mental Health: A Look Behind the Veil of Secrecy.” In 1996, he published four peer-reviewed articles about the economic, ethical, quality, and accessibility problems resulting from managed care. One of these articles reviewed the entire body of research used to justify managed care’s use of ultrabrief therapy. He found that a scandalous 100% of this research had been misquoted by managed care. Instead of supporting ultrabrief therapy and managed care imposed time limits, the research indicated the opposite, that managed care had a negative impact on outcomes. This finding was reported at the Dr. Harold Eist, President of the American Psychiatric Association (ApA), 1997 ApA Convention Presidential Press Conference.

To further health care reform, he has been active as a Board Member in the Colorado Psychological Association, has served on two committees of the American Psychological Association (APA), is a Board Member of the Division of Independent Practice of APA, was the Committee Chair for the Consumer’s Right to Know Legislation Committee, was a founding Board Member of the Colorado Advocates for Responsible Mental Health Services, was a founding Board Member of the Colorado Ad Hoc Committee to Defend Health Care, helped establish the Colorado Mental Health Insurance Action Line, was a Board Member and Executive Director of the National Coalition of Mental Health Professionals and Consumers, Inc. (NCMNPC), was Chair of the Board of Directors of the Patient Advocacy Coalition, and is Chair of the Board of Directors of Balanced Choice Health Care, Inc.

Several years into his activism, he began to search for better ways to design a health care system. Dr. Karen Shore, President of the NCMHPC, suggested the idea of gap payments in a reform proposal that she called Managed Cooperation. Although this proposal was limited, it stimulated thinking about the idea of restoring consumer cost consciousness and finding an alternative to managed care.

As Executive Director of the NCMHP&C, he prepared a supplement to a white paper, Collusive Behavior in the Managed Care Industry, which was presented to the Anti-Trust Division of the Department of Justice. This paper examined the economic systems underlying insurance-driven health care, managed care, monopolies, monopsonies, and free markets. Through this process, he realized that the current economic models for health care are dysfunctional, and that changing the underlying economic structure of health care is essential for designing the best possible system.

In order to both achieve universal coverage and restore healthy economic forces, he realized that two plans would be necessary. The difficulty with other two-tiered proposals had been that the second tier is prone to under-funding and cannot protect the poor from being limited to substandard care. In 2003, Dr. Miller came up with the idea of the Mandatory Funding Split, which preserves funding, and consequently quality, in the Standard Plan. This was a key idea necessary to create a complete system.

An early version of Balanced Choice was entered into the O’Connor Report, “Build an American Health Care System” contest. Balanced Choice was one of the finalists, but did not win the top prize. Feedback indicated that this early version was too difficult to understand. Audiences generally responded positively to the Balanced Choice ideas, but promoting Balanced Choice needed a reference document, a book, to clearly describe the entire proposal.

Since the contest, Dr. Miller has used his time and energy to develop a comprehensive and clear explanation of the Balanced Choice proposal. It is now available in Balanced Choice: A Common Sense Cure for the U.S. Health Care Systems.

Dr. Miller believes that Balanced Choice is the proposal that has the best possibility of resulting in desirable health care reform. It is a proposal that creates functional market dynamics and provides universal coverage. It accomplishes this without government price controls or managed care. It satisfies the concerns of both liberals and conservatives. It costs less overall than is currently being spent on health care. It is the most beneficial proposal for consumers, providers and employers.

As Chair of the Board of Directors of the nonprofit, Balanced Choice Health Care, Inc., Dr. Miller continues to use his time and energy to promote health care reform.

For more information about Dr. Miller's innovative health care reform proposal and how it provides universal coverage, visit www.BalancedChoiceHealthCare.org.

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Balanced Choice: A Common Sense Cure for the U.S. Health Care Systems
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