My Turn: End surprise medical billing by standing with patients

For the Monitor
Published: 7/19/2019 9:26:21 AM
Modified: 7/19/2019 9:26:11 AM

Patients pay their insurance premiums every month and expect that their coverage will be there for them when they need it. Sadly, more and more patients are blind-sided by surprise medical bills – unexpected medical expenses that occur when insurance companies refuse to cover out-of-network expenses the patient never knew they incurred.

Surprise bills most commonly occur after unanticipated visits to the emergency or operating rooms. During such emergencies patients shouldn’t have to worry whether their insurance will cover a potentially life-saving treatment.

Vulnerable patients are shocked to find out after the fact that an out-of-network provider had performed a test or other component of the procedure. Health insurance is meant to protect patients when they are at their most vulnerable, but insurance companies are failing to hold up their end of the bargain.

Surprise billing is becoming more prevalent as insurance networks get smaller, even as premiums and deductibles grow higher.

I read about a Seabrook woman who felt faint and visited a local emergency room. She believed her trip would be covered by her insurance, but she received a bill for over $1,600 because the doctor she saw was out of her network.

According to a recent poll, two-thirds of Americans worry about being able to afford emergency medical treatments. In fact, surprise medical bills are the most common fear among American patients.

Last month, President Donald Trump hosted a White House ceremony where patients shared their heartbreaking stories about receiving surprise medical bills. And earlier this year, Sen. Maggie Hassan’s guest to the State of the Union address was the same Seabrook resident who faced a surprise bill after her emergency room visit. This problem is not going away – in fact, it’s getting worse.

It’s time for Washington to hold insurers responsible for saddling patients with surprise medical bills.

As a nurse anesthesiologist, I am part of a community of medical providers across the country committed to treating all patients. It’s our responsibility to provide the best care possible. Insurers should have to pay reasonable rates for these unexpected expenses that typically happen when patients have no ability to decide where or from whom they receive treatment.

Profits for major insurers have increased by $12 billion in the last five years, and the three largest insurance companies control more than 80% of the market. However, insurers continue to deny network contracts to doctors and drop physicians from existing networks.

The solution to ending surprise medical bills already exists. Congress should protect patients with an independent dispute resolution system that removes patients from the middle of billing disputes and lets doctors and insurers negotiate payments with health care experts.

Additionally, Congress must also create adequate network standards ensuring that providers remain in network.

Republicans and Democrats have a golden opportunity to come together to protect patients when they are at their most vulnerable. No patient should ever have to receive a surprise medical bill from their insurer when they are unable to see a provider in their network.

(Kristen King lives in Concord and is a certified registered nurse anesthesiologist in New Hampshire)

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