Fixed rates could have unintended consequences
Kudos to Congress for taking up the issue of surprise medical bills. But a word of warning: This problem is not as simple as setting a fixed rate for what out-of-network providers can charge.
That so-called “solution” would cause still more problems. Disallowing emergency and urgent care providers to negotiate their own fair market rates would put them at the mercy of insurance companies, forcing many out of business and leaving many patients without access to important medical care. Instead of making life easier, rate setting can lead to doctor shortages, making it even harder for patients to find a provider covered by their insurance.
The better option is a system that sets guidelines for insurance companies’ provider networks and uses an independent dispute resolution system to remove patients from billing disputes and encourage doctors and insurers to reach a fair agreement about out-of-network rates and reimbursements.
We cannot “solve” the issue of surprise billing if we do it by making medical care harder to access.