Tags: Health Topics | Healthcare Reform | insurance | doctors | congress | charlie kirk

Charlie Kirk: Government Rate Setting Will Cut Access to Care

a woman is shocking to read the contents of a mailed medical bill
(Tapio Salmela/Deamstime)

By    |   Monday, 18 November 2019 04:32 PM

A well-meaning piece of legislation authored by Congress to stop a relatively infrequent, but undesirable circumstance from occuring ends up backfiring and making the problem much worse. Stop me if you've heard this one before.

Allow me to shed some light on the latest in a long line of congressional meddling gone wrong.

This specific episode of Congress ignoring foreseeable and explicitly warned-about unintended consequences of a proposed bill has to do with "surprise billing." In the context of healthcare, surprise billing is when people who have health insurance inadvertently end up on the hook for a very expensive medical bill after using an "out of network" doctor, hospital or emergency room.

While surprise billing is deeply and legitimately upsetting, it often also comes with significant financial duress and crisis. Whether you're 56 or 26 like me, Republican or Democrat, every American would prefer a world with less surprise billing rather than more. All Americans should similarly agree that when Congress gets on its soap box — in a virtue-signaling effort to address such an obvious problem — the resulting bill should actually make the problem better, not worse.

If you're skeptical about that simple logic applying to Congress, you'd be right.

Victims of surprise billing might be interested to learn that Obamacare significantly exacerbated the problem by encouraging health insurance companies to tighten the restrictions on their "networks." Another highly relevant fact is the same insurers, which were practically Barack's co-authors on Obamacare, facilitated by their tremendous clout and well-financed support of the bill — and have profited lavishly from its changes — are also leading the surprise billing "reform" efforts. Surprise! Corporate cronyism and corruption at work again.

The insurance company's "networks" are just price agreements they have with some universe of doctors, hospitals, and other healthcare providers. The providers, hoping to gain access to additional volume of business from the insurers' clients, agree to charge a lower price than they otherwise would. The problem arises when someone visits a doctor (e.g. a specialist) who is not part of their insurance company's network. In that case, the doctor bills his normal (higher) rate, the insurance company pays out its normal (lower) reimbursement, and suddenly the unsuspecting patient is on the hook for the balance.

In a world where the health insurance company did not write Congress' healthcare bills, it might seem obvious that the company you are paying every month to handle your healthcare needs when they arise should be encouraged to get with the "out of network" doctor and work it out among themselves. Instead, Congress is gearing up to make it easier for insurance companies to legally stiff doctors, hospitals, and other providers.

Now, even if some of those people, kind of, sort of deserve it, (like hospitals that terrify naive patients with "charge master" bills at exorbitant prices no insurer would ever dream of paying) it still does not get us what we want, which is fewer surprise billing instances without otherwise harming the current quality of patient care.

To put this in simple economic terms, the end result of Congress putting its thumb on the scale for insurers over doctors is the government artificially decreasing the demand for healthcare providers. In other words, if your doctor realizes he or she might not get paid for a given treatment or procedure, depending on where you live, the relief of no surprise billing might be painfully offset by no more access to your doctor.

Meanwhile, these proposals do not do anything to force the insurance companies and providers to both come to the table and work out their issues before it ends up wiping out some well-meaning family that accidentally got an extra X-ray and now cannot pay the rent.

If Congress could channel some of the energy spent racing to the microphones to declare how deeply they are against something bad, into studying whether their ideas for improving the situation pass basic laws of economics, we all might be better off.

In the meantime, stay healthy, and if you're not, stay paranoid.

Charlie Kirk is the founder and executive director of Turning Point USA, the nation's largest and fastest growing conservative youth organization with a presence on over 1,400 college and high school campuses; he is also host of "The Charlie Kirk Show."

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Congress is putting its thumb on the scale for insurers over doctors, meaning the government is effectively artificially decreasing the demand for healthcare providers, Turning Point USA's Charlie Kirk writes.
insurance, doctors, congress, charlie kirk
Monday, 18 November 2019 04:32 PM
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