It looks like Congress will have surprise medical bills near the top of their to-do list this fall. But as with many issues, the real question is whether their answer to the problem is the right one.
The proposals Congress is considering now offer two possible paths. One path involves the government and insurance companies deciding how much to pay doctors through “rate setting.” (As you can imagine, insurance companies and their lobbyists love this idea; it puts the government’s thumb firmly on the scale in their favor.) Based on what happened when they tried this in California, we can expect this path will lead to doctors and hospitals getting squeezed out of business, especially in rural areas.
The other path, laid out in the Stop Surprise Medical Bills Act proposed by Senator Bill Cassidy (R-LA), resolves the actual billing dispute while taking patients out of the middle of it. Insurance companies and health care providers get to make their case in front of a third party, while patients have access to affordable health care when they need it.
But as U.S. Senator Chuck Grassley, R-Iowa, noted at a recent event in Spencer, New York has successfully instituted a system similar to the one laid out in Senator Cassidy’s bill. Other states, like Texas, took notice and passed their own versions of the New York plan.
Senator Grassley’s comments are even more impressive given that the health insurance industry lobby has put on a full-court press trying to bend surprise medical bill proposals their way.
Rural areas often depend on hospitals and a small group of doctors for their health care needs. Rate setting will severely limit access in areas that have margin to lose health care providers. The bottom line is that our more rural, ag-focused based communities will have a tough time getting the health care they need if the federal “solution” for surprise billing leans on rate setting.
Senator Grassley has obviously thought through these issues carefully. Hopefully others in Washington will follow his lead.