OPINION:
Voters in North Carolina and across America regularly cite health care as the No. 1 issue on their minds, and for good reason. It’s what politicians call a pocketbook problem because it hits regular people where it hurts the most, draining their budgets to the tune of thousands of dollars every year. Sometimes these costs are expected, other times they come as a complete surprise (and not the good kind).
In parts of North Carolina, 40 percent to 50 percent of all trips to the emergency room now result in a surprise medical bill. It often occurs when a patient is taken to a hospital inside their insurance network only to be treated by an out of network doctor. Weeks later — surprise! — a bill for thousands of dollars shows up in the mail.
As the surprise billing phenomenon has grown in recent years, the chorus of voters calling for change has grown with it. Perhaps that’s why Congress is now examining several ways to put a stop to this egregious practice. But not every proposal is created equal. Some fall victim to the law of unintended consequences.
One legislative proposal involves government-set cost controls. This anti-free market approach, whereby government sets artificially-low fixed rates for medical care, ends up reducing not just cost but access. When doctors lose significant income, it can put them out of business or drive them out of rural areas.
This is what happened after California adopted the rate-setting approach. It drove thousands of doctors out of lower-income areas and caused multiple hospitals to shut down. North Carolina can’t afford the same fate. Already, five rural hospitals have closed down in our state since 2010, leading to what some are calling “health care deserts.”
A real solution should enable doctors and insurance companies to reach a fair-price agreement for out-of-network care while taking the patient out of the middle of the dispute process. One legislative proposal would achieve exactly that. It’s called the independent dispute resolution system. It allows doctors and insurers to bring their claims before an independent arbitrator, who will resolve payment differences in a fair and evidence-based manner. The patient never has to worry about the outcome.
This is the right approach for North Carolina and for America. It would protect patients from surprise billing while also preserving access to care in rural areas of our state. How can we be so sure? Because it’s already been tried in New York to great effect. Health care costs have fallen and there have been no adverse effects on access.
North Carolina’s representatives in Washington should get on board with independent dispute resolution. Sen. Thom Tillis, for example, should lead on this issue by signaling his support for the Senate’s STOP Surprise Medical Bills Act. It already has the support of a broad bipartisan group of senators. Time for Mr. Tillis to add his name to the list.
In the House, Rep. George Holding is already showing strong leadership by co-sponsoring the bipartisan Protecting People from Surprise Medical Bills Act, which takes the independent dispute resolution approach. It’s time for the rest of the North Carolina congressional delegation to get on board and push the legislation across the finish line.
As North Carolina and our country barrel ahead into another raucous election year, we can bet there will be numerous political distractions and sideshows. But these must not obstruct the true work of legislating and solving problems, especially on the issue Americans consistently rank as the most important.
By solving the surprise medical billing crisis through independent dispute resolution, Mr. Tillis, Rep. Holding and every member of Congress could solve a major pocketbook problem, delivering a win for themselves and their constituents. Why not seize the day?
•Todd Johnson, a Republican North Carolina state senator, serves as a member of the North Carolina Board of Community Colleges.
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