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A Better Solution to Surprise Medical Billing

POSTED BY Galen Institute on February 11, 2020.

Congress is right to be concerned about the issue of surprise medical billing.  It’s unfair to patients who play by the rules, go to their insurer’s in-network facility for care, and months later receive a bill from an out-of-network provider, sometimes costing patients thousands of dollars in unexpected medical bills.  Surprise bills are especially unfair to patients in emergency situations.

Congress has spent months searching for “middle ground” between insurance companies that want the government to force non-network doctors to accept network rates, and doctors who want the government to appoint arbitrators to decide how much insurers should pay non-network doctors.

Both approaches use the heavy hand of government to either force doctors and insurers who have not contracted with each other to accept rates set in contracts they haven’t signed, or to force parties into binding arbitration when payment disputes arise. Either approach uses rate-setting that would invite further government intervention in the private practice of medicine.

Effective market-based solutions to protect patients and prevent surprise billing should not involve government rate setting or government-forced arbitration. To break the logjam, Congress should pursue a third way, one that would eliminate surprise bills by giving patients honest information before they receive care. 

Congress should require truth in advertising so timely pricing information is available in advance to consumers.  It should impose penalties on insurers who represent facilities as in-network and facilities that represent themselves as being in-network, if those facilities permit physicians to balance bill for services.

Congress also should enforce price transparency to protect consumers from misleading information and ban balance billing for emergency services provided at non-network facilities.   

While the temptation to solve a political hotbed issue like surprise medical billing through federal overreach is strong, we encourage you to work toward solutions that increase the power of patients, not the federal government. 

Signatories:

Joseph R. Antos
American Enterprise Institute

Brandon Arnold
National Taxpayers Union

Christian N. Braunlich
Thomas Jefferson Institute for Public Policy

Jordan Buzza
Christ Medicus Foundation 

Mike Chupp MD, FACS, FCS (ECSA)
Christian Medical Association

Robert Fellner
Nevada Policy Research Institute

Edmund F. Haislmaier
The Heritage Foundation

Jonathan Imbody 
Freedom2Care

Bethany L. Marcum
Alaska Policy Forum 

Tom Miller
American Enterprise Institute 

Nina Owcharenko Schaefer 
The Heritage Foundation 

Sally Pipes
Pacific Research Institute 

Richard E. Ralston
Americans for Free Choice in Medicine

Thomas Schatz
Council for Citizens Against Government Waste

Roger Stark
Washington Policy Center

Grace-Marie Turner
Galen Institute

Elizabeth Wright
Council for Citizens Against Government Waste

Saulius Anuzis
60 Plus Association

Doug Badger
Galen Institute & The Heritage Foundation

Louis Brown Jr., J.D.
Christ Medicus Foundation 

Tim Chapman
Heritage Action for America 

Ryan Ellis
Center for a Free Economy

Marie Fishpaw
The Heritage Foundation

Rea Hederman
The Buckeye Institute

Phil Kerpen
American Commitment

James L. Martin
60 Plus Association

Robert E. Moffit, Ph.D. 
The Heritage Foundation

C. Preston Noell III
Tradition, Family, Property, Inc.

Michael Parker, MD
Catholic Medical Association

The Honorable Rick Santorum
Patriot Voices 

Jennifer Schubert-Akin
Steamboat Institute 

Jameson Taylor
Mississippi Center for Public Policy 

Steven White, MD
Catholic Medical Association 

Affiliations listed for identification purposes only.


https://galen.org/assets/Letter-to-Congress_Better_Solution_to_Surprise_Billing.pdf

Filed Under: Forbes, Grace-Marie Turner, Health Insurance

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