Republicans, do not miss the government-sponsored Medicare for All surprise


TheEuropean Democrats, led by Representative Pramila Jayapal, D-Wash., Presented on Wednesday a revised law on government-funded health insurance for all, while Republicans prepare their opposition and Democratic presidential candidates questions about what medicare could mean and what role should be in setting rates for private insurers.

Jayapal's bill largely resumes a 2017 proposal by Senator Bernard Sanders, I-Vt., But the heart of every Medicare for All proposal has remained the same: government price controls for private health coverage. The issue of price controls could be one of the main political problems of the 2020 Democratic primary and a vital way to differentiate the most progressive left-wing candidates from the other nominees, but Republicans also pose the question.

The great Republicans called for hearings on the subject while pointing out that they opposed it, and WRC Committee member Kevin Brady, R-Texas, said "We are going to raise the curtain on" Medicare for all ", so the American people can really evaluate it. While the Conservatives in the House of Representatives are trying to "lift the curtain" on the lump-sum pricing proposal, they may be surprised to find that the heart of the "Medicare for all" approach has been proposed: a solution health right and left.

During a recent roundtable at the White House, President Trump said reducing unanticipated medical bills would be a top priority for his government. He followed closely the ongoing momentum in Congress, where a handful of Republican and Democratic lawmakers have already begun promoting legislation aimed at solving the problem. . Unfortunately, their focus on setting price controls by the federal government will hardly protect patients from rising health care costs and ultimately open the way for Democrats to realize their dream of "Medicare for all. "

Work to solve the problem of surprise billing began in Congress last fall and the bill released by members of the Senate Working Group on Health Care Price Transparency offers the biggest surprise nowadays. The Patient Protection Against Unforeseen Medical Bill Act is one of many projects that would require the government to establish payer reimbursement rates for privately insured patients who receive care outside the network.

It should not be surprising to find the declared champion of a progressive approach to single payer health care, Senator Michael Bennet, D-Colo., Who advocates for rates set by the government, but the Republican, Senator Bill Cassidy, -La., joins him to lead the charge should concern both conservative Republicans and moderate Republicans.

The approach championed by Cassidy may seem familiar, these price controls are often referred to as "setting the rate for any payer". Perhaps a better term is: "America's backdoor for single payer health care". A single payer system would eliminate private costs. plans for a government plan, and setting the rate for all payers achieves the same result by setting a price that each health insurance pays for a given medical procedure, ignoring a range of factors taken into account when providers establish costs for the provision of care.

Legislation requiring the health system to set a rate set by the government and which will pay for care will be of no avail to ensure the availability and quality of health service providers within the health plan networks. This disrupts the system, which deters commercial insurers from designing a complete network and could limit patients' access to long-term care.

In addition, underpayments based on Medicare rates have traditionally resulted in higher commercial rates that impact patients in the form of higher premiums, deductibles and co-insurance, or a combination of higher premiums and higher premiums. non-refundable fees. Even those who can afford coverage can end up with less access to providers for non-urgent care because setting reimbursement rates for off-grid care without taking into account the costs Underlying issues related to the provision of care could result in longer wait times, a reduction in the number of nurses, vital services such as high-risk nurseries and cause more closures. hospitals, especially in rural areas.

We can all agree that health surprises are rarely welcome, especially when it comes to medical bills. But those who are seriously looking for a surprise billing solution should not be content with something that puts America on the path to a single payer system, such as Medicare for All.

As the Conservatives attempt to "lift the curtain" on the single-payer billing proposal, they must seriously evaluate each proposal and continue to take a stand against any proposals that support the government's tariffs for private health coverage.

There are better ideas that align with bipartite principles. Once we make sure that the patient is protected and has a certainty about cost sharing limited to the internal costs of the network, the cure for surprise billing is not that complicated. If we offer solutions that recognize the dangers of government pricing and the role that both vendors and commercial insurers play in ensuring access to quality care, market forces and trade-offs will lead to better outcomes. for all patients.

Jason Pye is the Vice President of Legislative Affairs for FreedomWorks.

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