The modern health care system doesn't follow any kind of traditional free market dynamics. It's a Byzantine mess removed where patients are a hospital's product, not its customer, with insurance companies trying to do the least for each so they can make the most. In all of this, said insurance has become vital for financing routine procedures, rather than just emergencies.
The Democratic candidates for president – with preposterous moon-promises of magically providing health care to all of Latin America – keep wanting to feed the insurance beast, while a growing bipartisan coalition in Congress have figured out the way to starve it.
Enter the Stopping The Outrageous Practice of Surprise Medical Bills Act, proposed by Sens. Bill Cassidy, R-La., and Maggie Hassan, D-N.H. The bill aims to reduce health care costs with a prescription of free-market economics by introducing transparency and fighting "surprise billing," when patients receive a bill from an out-of-network physician even when they're at an in-network facility.
The bipartisan plan combines network matching, rate benchmarking, and arbitration to protect patients without disrupting the healthcare delivery system, which radical far-left plans would. (Spoiler: you can't make health care better by driving doctors and hospitals out of business.) It introduces an independent dispute resolution (IDR) among practices and health plans when disputes may arise, finding quicker solutions and avoiding costly litigation.
IDR is a solution with a well-established track record of protecting patients and preventing surprise medical bills from New York to Texas. It's succeeded at the state level and it's time to go national with it. IDR protects patients from receiving a surprise medical bill – like when you got an operation from an in-network doctor but an out-of-network anesthesiologist – and removes the patient from billing disputes between doctors and insurers.
IDR also maintains a balance between doctors and insurers while preventing the insurance industry from setting its own prices, which would have been disastrous for health care providers.
With price controls, insurance companies can stiff doctors and hospitals, providing a potential windfall of the insurance industry. As premiums under Obamacare have soared, the largest insurers in the country have enjoyed rising profits. For example, United Health Group enjoyed $10.6 billion in profits in 2017 and an earnings growth of 56 percent.
Recent far-left proposals to address surprise medical bills would be a giveaway to insurers, who've spent more than $70 million lobbying Congress for legislation that would protect their profits instead of patients. At a recent House committee hearing, Republican members warned against the potential damage of insurance price-fixing proposed in the competing Consumer Protections Against Surprise Medical Bills Act of 2020.
Conservative advocates like Heritage Action for America, Club for Growth, Americans for Prosperity, and others have been warning against price-fixing for a long time, but at the hearing even Rep. Kimberly Schrier (D-Wash.) warned that the bill "puts hospitals at risk."
Any legislation that would hurt patients, shut hospitals' doors, and prompt doctors to retire early is not a solution to surprise medical billing. Sen. Cassidy and Hassan's plan has the potential to stop surprise medical bills with legislation while avoiding the pitfalls of price fixing. It would providing a meaningful dispute-resolution component, prevent insurance companies from exploiting loopholes to set rates, and create an interim payment so insurers can't confiscate payments intended for doctors.
As a society, we determined a long time ago to stop rate setting. The health care system (certainly) isn't perfect, but now we have a chance to solve surprise billing solution without blowing up the parts of the system that are already working. President Donald Trump has voiced strong support for transparency as a free-market solution.
The Cassidy/Hassan bill keeps the market alive by creating an equal playing field in contract negotiations between plans and providers whereas the competing legislation gives all of the market power to the insurance companies. Insurance companies have been raking in record profits under Obamacare, they don't need any more government give-aways.
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