Several bills are working their way through this legislative session that deal with doctor and hospital payments. The first of these is HB 1693 – establishing a system for setting rates for health care services. (here) This bill would require a nine member “commission” to determine pricing that hospitals and physician groups could charge. Providers have minority representation on the commission, with only one member representing hospitals and one member representing other providers.

The purpose of the bill is to essentially set prices that providers can charge. Another way of thinking of this bill is that it would set price controls on hospitals and doctors in Washington state. Price controls may seem reasonable to control overall costs of health care. In reality these controls would increase political involvement in our health care system and would potentially limit patient access to medical care if providers could not cover their overhead with low reimbursements.

The other bills are HB 1185 and SB 5319. (here and here) These bills would require the state to pay Medicaid providers who have contracts with the state Health Care Authority at the same rate that Medicare pays for comparable services. Medicare reimburses doctors on average 70 percent of what private insurance pays. Medicaid reimburses physicians on average 40 percent of what private insurance pays for comparable services.

There are two problems with these bills. First of all, most doctors limit the number of Medicare patients they can see because Medicare payments won’t cover their office overhead. Increasing Medicaid payments to those of Medicare will help doctors, but won’t solve the problem of inadequate reimbursement. The second problem is that the bills have no fiscal note. Obviously, an increase payment to doctors in the Medicaid program will result in a greater financial burden for state taxpayers. At the very least, these bills should include an estimate of the cost to state taxpayers.

If politicians really want to decrease health care costs, they should work on major reform that puts patients in charge of their health care decisions and their health care financing. Elected officials should strive for more patient control and less political involvement. (here)