White House: We’re ready to bring an end to surprise medical bills, is Congress?

Nov 27, 2019 | Arbitration, Market Approach, Private Equity

Below is an excerpt from an op-ed published in USA Today. To view the full op-ed, click here.

White House: We’re Ready To Bring An End To Surprise Medical Bills, Is Congress? (Nov. 27, 2019)
By Joe Grogan, Director of the White House Domestic Policy Council

After weeks of inactivity, lawmakers have returned home for Thanksgiving where they will get hit with another round of ads from the swamp’s special-interest moneymakers who value profits more than patients. They need to listen to Drew Calver’s story and hear how some tried to turn a medical emergency into a financial killing.

Earlier this year, President Donald Trump stood with Drew and his wife Erin from Austin, Texas in the Roosevelt Room of the White House and discussed Drew’s jarring story of a hospital system that sought to take advantage of their family’s emergency.

Drew had a heart attack in 2017 and went to a nearby hospital. Thankfully, he survived. The hospital was out of network, but his insurer paid the hospital a generous amount nonetheless — nearly $56,000 for his four day hospitalization. The hospital saw this as too little, though, and billed Drew for an additional $109,000.

 

Drew thought he was totally covered

This came as a “surprise medical bill” to Drew, who has insurance through his job as a high school teacher and expected to be covered from financial tragedy if he ever faced a medical emergency. The hospital all but admitted how ludicrous the bill was when they dropped Drew’s balance down to $332.29 after there was public outcry over the absurd cost.

These “surprise” bills are not accidents. Research by investigators at Yale has shown that hospital staffing companies, owned in part by private equity firms, use balance bills as a systematic way to increase revenues that the market wouldn’t otherwise bear by creating leverage with insurance companies.

When Drew had his heart attack, he didn’t stand a chance against the special interests. In 2015, one of the private equity firms studied by the Yale economists celebrated the announcement of a “strategic partnership” with Drew’s hospital.

This bad behavior only gets worse when you look at the air ambulance industry. The largest air ambulance operator was publicly-traded until it was acquired by a private equity firm in 2017. In the decade prior to that acquisition, the firm had almost quadrupled its average charge per transport, from $13,000 in 2007 to $49,800 in 2016. The company is unapologetic in extracting money from patients. ABC News has found hundreds of lawsuits by this firm against patients to collect balance bills or garnish wages, including 104 suits in South Carolina alone.

 

Conservatives can’t sit out of the health care conversation

Some conservatives have warned that we need to tread carefully before addressing balance bills, for fear of unintended consequences. Proceeding thoughtfully is always wise, but, if we do nothing, the special interests will have won, because the status quo is working quite nicely for them. And the patients will have lost.

If we cannot fix our most obvious market failures in health care, why should Americans trust that private health care options will work for them? If your on-the-job insurance cannot protect you from financial devastation in an emergency because private equity is exploiting situations where patients have no meaningful opportunity to choose their provider, then we are just providing fodder for the radical socialists who say the only solution is to throw in the towel on private markets altogether.

Surprise medical billing is exactly why President Trump was elected. He is willing to stand up to big businesses pouring millions into misleading advertisements. He is diving into difficult policy questions and making sure that real Americans come out with a better deal. He has been the vocal leader that we need to protect patients from surprise bills.

Now it’s time for Congress to act. Congress has taken the first steps to answer the call — the Senate HELP Committee and the House Energy and Commerce Committee have reported out bills addressing surprise billing. Now, lawmakers, while you’re at home eating turkey and watching football, I ask that you change the channel when the private equity ads come on. Instead, listen to real Americans who are being hurt by special interests, and come back to Washington in December ready to vote to protect patients from surprise medical bills.

To view the full op-ed, click here.