EDITOR: Doctors and nurses deserve America’s support. When it comes to managing the COVID-19 pandemic, they are on the front lines. Meanwhile, some doctors are facing serious financial stress because elective care has been cancelled.
That Congress is considering new legislation as part of the COVID-19 relief package to impose more “rate-setting,” a form of price control, upon the medical community is baffling. This legislation would be financially punishing to the medical community.
The legislation aims to protect patients from “surprise medical bills.” The goal is noble. No patient should face a financially devastating bill when, through no fault of her own, she receives treatment out-of-network.
Rate-fixing would set a benchmark rate, highly discounted, at which insurers reimburse doctors and providers when surprise bills occur. That’s big government at its worst. Rate-setting is economically unsound, arbitrary, and ultimately punishes patients. When doctors exit the marketplace, as has been the practice under Medicaid — another program replete with rate-fixing — patients lose access to quality providers.
Alternatives to rate-setting exist. Several states, such as New York and Texas, have successfully adopted an arbitration-based model for resolving surprise billing disputes. Patients are protected, and insurers and providers resolve their disputes in front of an independent third-party.
Congress has an opportunity to get this right. Reject more damaging rate-setting, and instead adopt market-based and fairer reforms based on arbitration. At a time when medical providers are taking on considerable risk and making sacrifice, they deserve better than financially-crippling rate-setting proposals.
— Richard Sokol via letters@sentinelcolorado.com