Posted by on December 26, 2019 11:37 am
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By Andy Blom, TES Contributor


When setting policy that affects millions of Americans every day, Congressional leaders should create a policy that is well-intentioned without producing unintended consequences.


Unfortunately, that appears too much to ask for when it comes to the Lower Health Care Costs Act (LHCC) currently being proposed by Senator Lamar Alexander (R-TN) and others.


Good intentions aren’t good enough when it comes to setting policy, and our leaders know that. It’s a good thing to propose changes to our health care system to eliminate surprise medical billing, which is a real problem for patients who receive emergency medical care. But when that proposed policy produces unintended, harmful, and costly consequences, it’s time to see if it’s such a good policy proposal after all.


At the bidding of the insurance lobby, leaders like Sen. Alexander are proposing government-controlled price setting as a way to eliminate surprise medical bills incurred by patients receiving medical care and services not covered by their insurance network. Price setting should ignite outrage in Americans who want a solution to medical billing problems, not a bigger problem.


The Association of American Medical Colleges agrees. In a statement issued after the LHCC bill passed the Senate HELP Committee, they outlined several critical issues with the bill, not least of which is that “this bill could keep patients from accessing the high-quality, effective care that is available only at teaching hospitals.”


In their statement, they expound on these problems by writing:

“Section 302 of the bill would allow insurers to create networks that exclude teaching hospitals, thus restricting patients’ ability to seek care at these facilities that provide a number of vital services unavailable elsewhere. For example, while they only represent 5% of hospitals nationwide, AAMC-member teaching hospitals operate 98% of all Comprehensive Cancer Centers, 68% of all level-one trauma centers, and 63% of all pediatric intensive care units. The availability of these services – and the high-quality care provided at teaching hospitals – result in up to 20% higher odds of survival for patients treated at these institutions when compared to those treated at other hospitals. Reducing access to these institutions puts the health of patients at risk and increases costs to the patient should they seek the care they need outside of their insurance network.”


Why would Congressional leaders propose a bill so devastating to doctors and patients across the country? Because they’re taking their cues from the powerful insurance lobby instead of listening to the experts providing quality care to their constituents. 


We don’t need Sen. Alexander’s legislation, because a reasonable, common-sense solution exists that is completely overlooked by the LHCC’s overly-simplistic, dismissive “solution” to surprise medical billing. It’s called an independent dispute resolution board (IDR) and has been used successfully for medical cost disputes, and even in contract disputes in Major League Baseball.


It allows patients to receive the quality emergency care they need and deserve and allows both medical practitioners and insurance agencies to take their billing disputes to an independent arbitration board for resolution. 


Fortunately, there is a bi-partisan group of leaders in Congress pushing to make this happen. Led by Senator Bill Cassidy (R-LA), it proposes a solution to the crisis of surprise medical billing in our country by setting up IDR boards, allowing people to keep receiving the care they need and holding insurance companies responsible for providing better coverage in a larger network.


This is a plan that all Americans can support because it’s good for all Americans. It’s a common-sense solution to a real problem. That any of our leaders would suggest otherwise should give us pause.


Andresen Blom is a Washington based policy and political analyst and author who has been published in The Wall Street Journal, The Hill, and Politico.