Arbitration is medical-bill answer Since last summer, one federal policy debate has been simmering in the halls of Congress: how to deal with “surprise medical bills.” Colorado’s congressional …
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Since last summer, one federal policy debate has been simmering in the halls of Congress: how to deal with “surprise medical bills.” Colorado’s congressional delegation has an opportunity to build a bipartisan consensus.
Surprise medical bills are a real problem. No patient or family deserves to be financially devastated because they inadvertently obtain care out-of-network. When surprise bills occur, insurers and providers are left to negotiate a settlement. How that settlement is reached is the focus of debate.
Unfortunately, many proposals under consideration in Congress rely upon a technique called “rate-fixing” - essentially, price controls. Rate-fixing is big government at its worst: a one-size-fits-all approach that forces doctors and providers to shoulder the bulk of the cost of surprise bills.
Rate-fixing is bad for doctors and providers, but its real casualties are the patients who lose access to quality doctors and providers who refuse to serve patient populations subject to rate-fixing.
Congress can do better than rate-fixing. Several states have experimented with a form of arbitration called “independent dispute resolution” (IDR) that protects patients from surprise bills while treating both providers and insurers fairly. If a billing dispute cannot be solved, IDR stipulates that the insurer and provider present the facts in front of an independent third party. IDR motivates both insurers and providers to work hard to avoid surprise billings, since both have skin in the game.
Patients deserve protection from surprise bills, but not every solution is a good solution. Reject rate-fixing. Embrace arbitration.
Former mayor of Castle Rock
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