Comment by js2 | Hacker News Reader

Comment by js2 | Hacker News Reader

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Meanwhile, Congress passed a bill that's supposed to help with surprise billing. The Biden administration has started to implement it, but doctors and their representatives (Democrats and Republicans alike) claim the administration is not implementing the bill as intended and they are favoring insurance companies over medical providers by trying to keep costs down.

> “The Administration’s recently proposed regulation to begin implementing the law does not uphold Congressional intent and could incentivize insurance companies to set artificially low payment rates, which would narrow provider networks and potentially force small practices to close thus limiting patients access to care,” Rep. Larry Bucshon (R-Ind.), who is a doctor and helped spearhead a letter of complaint this month, said in a statement to KHN.

https://khn.org/news/article/surprise-medical-bills-policy-c...

This shit makes my blood boil. Various vested interests, but mostly doctors, have stymied virtually all legislation (the ACA, Medicare and Medicaid being the notable exceptions) for a century.

https://pnhp.org/a-brief-history-universal-health-care-effor...

Those greedy doctors trying to protect their livelihoods from a bill that gives insurers an easy path to drive down their reimbursement when an alternate method of doing the same thing (New York's law on surprise billing) exists that does not have that same feature. I for one know that software engineers would certainly support bills that would reduce their pay for the greater good! Physicians are the only group that everyone expects to work for less and less money. It may surprise you, but most software engineers will have an easy time outearning the majority of physicians. It's not the 80s anymore. Doctors aren't super rich. Doctors aren't the ones who made you sick, but they are the ones who trained for 7+ years to take care of the problem. Shame on them for wanting to earn a living.

https://www.bls.gov/ooh/mobile/highest-paying.htm

In the states that use benchmarks similar to what doctors are suggesting HHS use instead of the agency's current proposal --such as New York and New Jersey — the report found costs rising. New York, for example, has a "baseball-style" system in which the arbiter chooses between the offers presented by the provider and the insurer, although the arbiter is told to consider the offer closest to the 80th percentile of charges. "Since the amount providers charge is typically much higher than the actual negotiated rate, this approach risks leading to significantly higher overall costs," the report finds. In New Jersey, billed charges or "usual and customary" rates are considered.

"When the arbitration process is wide open, no boundaries, at the end of the day health care costs go up, not down," Becerra says of the methods doctors prefer. "We want costs to go down. And so we want to set up a system that helps provide the guideposts to keep us efficient, transparent and cost-effective."

The system chosen by the Biden administration is expected to push insurance premiums down by 0.5% to 1%, the Congressional Budget Office estimates.

https://www.npr.org/sections/health-shots/2021/11/22/1057985...

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