By David Greenberg for Greenfield Recorder
Patients get ‘surprise’ bills when their health insurance company refuses to pay for out-of-network treatments. This often happens when patients have little choice over where they receive care, such as an emergency room visit.
Watching the national debate over surprise medical billing makes it abundantly clear how committed health insurance companies are to padding their profit margins. Insurers have enjoyed record profits over the past five years, all while deductibles increase and their networks shrink. Insurers have a “solution” to the problem of surprise medical bills that allows them to make even more money.
The insurance companies say the answer is to set a consistent rate for care and services, indexed to in-network rates. But this would give insurers the ability to drive down both in-network and out -of-network rates by canceling provider contacts and renegotiating cheaper reimbursements.
This would have dramatic ramifications for health care providers. It means doctor shortages (especially in rural communities like ours) and fewer choices for patients seeking urgent medical care.
In contrast, a baseball-style arbitration model would allow providers and insurance companies to work out their differences before an independent arbitrator. In New York, where this arbitration model has been implemented, it has been used to settle over 2,000 billing disputes since 2015 when the law was passed.
This is a problem best solved at the national level. A state-by-state solution may leave patients vulnerable.
Please ask our congressional delegation to continue to work towards a solution that will protect patients nationwide from this harmful practice and to support Medicare for all, which will provide all of us with the highest quality medical care by eliminating insurance companies altogether.