Opinion: We need benchmarking, not arbitration, to quell surprise medical billing
Surprise medical bills expose Americans to the high prices and occasional greed lurking in the heart of our health care system. Medical insurers typically provide some insulation from these bills by negotiating prices for their in-network patients. In its effort to fix surprise bills, Congress must not undermine this key lever for controlling hospital and doctor bills by instituting an arbitration solution, which is strongly backed by organized medicine, that is now working its way through several Congressional committees.
The Protecting People From Surprise Medical Bills Act, introduced into the House of Representatives in June, would use arbitration to settle disputes over surprise medical bills. The bill stipulates that to resolve such disputes, an arbiter will typically pay out-of-network providers significantly more than the in-network rate. The average award — near the 80th percentile of physician billings — will ensure that it is almost always more profitable for a physician to be out of network than in it. This incentive will only increase over time as arbitration awards incrementally but continually rise with each new above-network arbitration decision.
