Reject this premature rate-setting deal

Before adjourning for the year, Congress reached a tentative so-called deal on two legislative proposals claiming to address surprise medical bills. However, the two proposals were already similar at their core: insurer-backed plans that use rate setting to give more power to the government and insurance companies, while making it harder for patients to receive care.

Therefore, there can be no claims of a compromise without support from doctors and health care providers. Token concessions don’t amount to a deal, and doctors are not going to be able to support legislation that doesn’t take substantive measures to protect access to care and ensure a level playing field with insurers, who have spent nearly $47 million advancing rate-setting legislation. Without a meaningful independent dispute resolution (IDR) component that allows for fair and equitable reimbursement rates, this premature deal must be rejected. In fact, it was not included in an omnibus bill that was approved to close out the year.

The agreement of two committees is reportedly based on a California law that allows the government to dictate fees. If rate setting goes forward, the results will be devastating. Simply put, when the government dictates rates, it leads to doctor shortages and hospital closures.

Nearly two-thirds of doctors in California report that their patients now have trouble getting timely access to care. This negative impact on health care delivery and availability is felt most acutely in our nation’s rural areas, which have lost more than 100 hospitals in the last decade.

Doctors have led the effort throughout this process to develop a solution that protects patients and maintains a balance in our health care system. The IDR process would settle billing disputes between doctors and insurance companies, guarantee that insurance companies are accountable to the government and to their customers, and eliminate surprise medical bills for patients once and for all.

Sheila Bush is executive director of the Wyoming Medical Society, a group that advocates on behalf of physicians.