Do we want a free health care market?
March 18, 2012 by nancy_barto
Then why have common sense reforms that will produce one been opposed, defeated and/or vetoed at the Legislature for the last 2 years – even with a Republican Governor and Republican supermajority?
The short answer is swarms of lobbyists. The longer answer is Legislators succumbing to lobbyists on issues that should be very clear.
Case in point: this week, after passing the Senate the House Judiciary Committee on Thursday had an opportunity to move SB 1384 to a full vote of the House. Unfortuntately, Republicans on the committee kept the bill from getting there. Watch the video of the hearing. Fast forward to the 1 hour 40 minute timeframe.
SB 1384 is a health care price disclosure bill - ensuring patients a transparent price for the most common procedures when paying directly – with cash or handling any insurance paperwork themselves if they have a Medical Savings Account. See a recent KPHO Channel 5 piece on the issue.
Consider the facts: Half of all health care spending originates from government and 90% involves a 3rd party payer.
As employers seek to lower their health care costs, many are offering employees Health Savings Accounts and incentivizing prevention. The missing element in the equation is transparent pricing for these cash-paying patients, but that information is hard to come by.
Opponents call government requiring price disclosure a mandate. The Goldwater Institute’s Byron Schlomach disagrees and testified in support of the bill saying in part, “the current system is not anything like a real market for the vast majority of patients and providers. Name another market where the government or some private company pays the bill for you. If car repair were nearly all paid by government or insurance, I would insist that there be a price posting law for those who didn’t have a third party payer, partly because the only way a third party payer system exists in the first place is because government effectively created it.”
Opponents also say they already provide such information to patients. If so, why the vehement opposition? The number of lobbyists opposing the measure tells the real story. 18-2. Eighteen lobbyists representing mostly insurers, hospitals and health plans signed in opposing the bill and nearly killed it in the Senate where, after passing the Senate Health Committee, opponents descended upon Senate leadership personally and the bill nearly didn’t come to the floor. Obviously there is something more at stake.
That something is competitive pricing and where more competition will lead…to a competitive free market health care system where less government & 3rd party monies control the pricing game.
Obamacare is now estimated to cost DOUBLE what was first projected over the next decade. $1.76 Trillion dollars. That’s a lot of money that will flow from government to insurers and health plans. With that much at stake, converting to a competitive free market will not come easy. Are elected officials up for the fight? Or maybe the question should be, “are Republicans willing to fight?”
Forbes contributor Avik Roy’s article, “Why do hospitals charge $4,423 for $250 CT scans? Blame Arizona Republicans” refers to SB 1384 in his piece.
Health insurance carriers have been quite expert at taking in premiums and avoiding paying out on claims. What was once a good concept has morphed into a massively profitable industry that has, as its goal, the generation of profits, and clearly NOT the provision of health care. Our system needs transparency. A true “Health Care Reform” plan would have 3 pillars. The first would be to allow inter-state competition so that we can all buy whatever health plan we want from any of the 50 states. The second pillar would be to allow for the importation of pharmaceutical medications from any modern country (Canada, England, France, etc.). The pharmaceutical companies say that we must pay more herein the USA to support their research??? Why shouldn’t the whole world market support their research? Opening up the market would create price competition. The third pillar is tort reform. If we doctors were freed from the need to practice defensive medicine, then cost would go down. Contrary to what the trial lawyers say, tort reform has decreased costs and medical malpractice premiums in every case. Just ask the physicians of Texas, Indiana, and California. Left wing policies only increase entitlements. As Margaret Thatcher said; “The only problem with Socialism is that sooner or later, you run out of other people’s money”
Hello Senator Barto. Your proposed legislation (SB 1384, 2nd session, 50th) mirrors corporate policy at my employer. Policy includes information resources available to each employee of the corporate plan that identifies the “billed cost” of each service for each provider that has ever been paid by the corporate medical insurance plan. The intent of the policy is identical to the intent of your proposed legislation.
The difference between the corporate policy and the legislation is that (a) the corporate policy utilizes “experience based” information gathered from actual billings; wheras (b) your legislation proposes to require providers to “up-front” provide their fee for the service.
I like your proposed legislation better, because it places a state wide uniform information system. It levels the playing field for all providers and all participants.
Your observations and frustrations on this issue are understood. Price disclosure is, as you cite, an important part of competition. The ability of health service providers to avoid disclosing an offering price is an interesting twist. And, it’s true; the provider need only “accept” or “reject” an insurance company “offer” of payment. The insurance company thus never actually knows, nor can it determine, whether its payment is competitive vs the service provided. Conversely, the provider never need disclose just how competitive it is willing, or not, to be.
I generally support your efforts. I’m in LD4, and do not know how my senator and/or representatives view this proposed legislation but will find out. Thank you for keeping me posted.
Resembles the NH bill hb1590 I introduced this past year, same opposition.
http://www.gencourt.state.nh.us/legislation/amendments/2012-0990H.html
Rep. Andrew Manuse, cosponsor, pointed this out to me, and I completely agree with your analysis of the resistance/opposition.
I’ve been complaining about the lack of transparency in medical billing for quite some time. I had to get an MRI and I could not get pricing information. The insurance company said they couldn’t give it to me because they didn’t know how it was being billed (even though the facility gave me the medical code they would bill). The medical facility couldn’t tell me because they claimed they didn’t know what the insurance would cover. So I could get nothing on billing! Would you ever go through the grocery store and not know the prices of what you were buying until you got to the checkout lane? NO! Why should healthcare be any different. This past legislature in the House failed the citizens of AZ in many ways. I am extremely disappointed in the lack of leadership of Andy Tobin.
“Would you ever go through the grocery store and not know the prices of what you were buying until you got to the checkout lane? NO! Why should healthcare be any different.”
Right Shelley! But it’s even worse than that. Would you go a grocery store that would not tell you the price of anything, did not bill you until one or two months later, then sent you five different bills, spread over the next two months, one for fresh food, one for packaged, another for meat, another to rent your shopping cart, and another for the services of the person on checkout. And that gallon of milk….$27.95.