Medical balance billing - A better solution
Recent surveys show that 20 percent of patients now receive a surprise out-of-network physician bill, even when they go to a facility that has a contract with their health insurer. (here) There is bipartisan work on the issue now moving through Congress.
The current proposed legislation involves two approaches. Insurance companies want out-of-network doctors to accept in-network payments. Physicians want a government-approved arbitrator to resolve the difference between in-network and out-of-network reimbursements. (here)
Both of these proposals are essentially price-setting on the part of the government. Both have strong lobby efforts and would further entrench the federal government in our health care delivery system.
There is a third way, one that allows the free market to resolve the problem. It would impose penalties on insurers that advertize facilities as being in-network and would penalize in-network hospitals and clinics that allow physicians to balance bill. This solution gives patients more information and control, while excluding heavy-handed government involvement.