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As tens of thousands of doctors, nurses, hospital workers, EMT’s and paramedics join forces to conduct a rescue mission on a truly historic scale, lawmakers in Washington are failing our front-line responders. Rather than fighting with these medical professionals, politicians are fighting for what benefits them politically and helping special interest groups.
As part of the coronavirus aid package, there is a bipartisan push to let the government set provider rates based on the average price for in-network services in a particular region. As a reminder, those discounted in-network rates are accepted because the insurance company funnels patients to them, so more volume for a discounted price.
The split screen is jarring. On one side, you have doctors risking their lives, working 18-hour shifts, only to have to sleep on a couch in their office because it’s too dangerous to go home and possibly expose their families to the novel coronavirus.
On the other side, you have politicians on both sides of the aisle jamming through legislation that would essentially cut the reimbursement rates for those very same doctors and other care providers.
True to form, politicians are not letting a crisis, when Americans are most in need, go to waste. This time it’s a scheme to benefit the health insurance lobby, which spent an astonishing $9.5 million in Washington for lobbying last year. I can guarantee that the financial wellbeing of doctors and nurses was not a topic often discussed during those meetings.
And now, in the middle of a jarring pandemic with millions of lives at stake, when doctors cannot afford to pay attention to the games Washington is playing, there is a push to cut doctors’ pay.
Imagine a firefighter racing to a burning building and city council members saying, “Now is the perfect time to cut their hazard pay.” This is essentially what is silently occurring with the supposed stimulus bill.
The impact of government rate-setting stretches beyond just doctors. Hospitals will be forced to cost-shift during a time of unprecedented stress on emergency rooms. Although the stimulus package affords a large sum of money to hospital systems, the non-hospital employed physicians, nurses and first responders are left to fend for themselves while being forced to cancel elective procedures — the very thing that affords them the ability to maintain their small businesses.
Our smaller, rural hospitals cannot afford a scenario that makes resources further scarce. Air ambulances and private medical practices that provide emergency transport and care in the hardest to reach communities would be forced to reduce costs and close locations if big insurance continues to get in the way. We have already seen a large amount of hospital consolidation and closings and small medical practices are being shut down because of changes under the Affordable Care Act.
In addition, this part of the stimulus package would make it even harder for vulnerable Americans to access higher quality medical care and even more dangerous in situations involving stroke patients where every second truly counts.
For years, health insurers have had almost unchecked power in the health care system, either squeezing providers like doctors, nurses and hospitals or leaving patients with bills they cannot afford. If we want to treat health care personnel and patients fairly, the first step is to allow patients more out-of-network options without subjecting them to draconian government-set rates. The second step is to establish fair arbitration rules so that health care providers and insurers can negotiate fair rates.
If insurers refuse to negotiate directly with the very people tasked with providing care for their own paying clients, then they should be required to arbitrate without a totalitarian threshold set to solely benefit the Goliath insurance industry. This would allow millions of Americans to retain access to quality, lifesaving medical care, ensure insurers are acting in good faith, and eliminate the possibility of a surprise denial of patients' medical bills and the resulting financial hardship.
There is a time and place to have a debate about reimbursement rates and how to bring health care costs down. The worst possible time? Right now — when the very people it impacts the most are too busy saving lives to realize their elected leaders are scheming to cut their pay.