Don’t blame doctors for unexpected bills

I would like to offer a different viewpoint regarding the Nov. 3 article, Miami lawmaker pushes bill to ban unexpected medical fees, on the so-called “balance billing” legislation (HB 221) authored by Rep. Carlos Trujillo.

Floridians receive medical bills that may be a surprise, but actually should be quite expected from hospitals and providers that aren’t covered by their policies. This occurs due to a misunderstanding between the patient and insurer over the inadequacies of an insurance network and a lack of disclosure from the carriers about pre-existing gaps in insurance coverage. Large deductible and higher patient responsibility plans, so common today, also contribute to unforeseen expenses.

As HB 221 foretells, insurers have begun a campaign to shift blame away from their industry or the inadequacies of coverage by targeting physicians. This is unfortunate because it is the doctors who provide what is often lifesaving emergency medical care, without regard to the patient's insurance.

It is a false accusation that physicians avoid network participation. Due to ease of financial transactions and relative certainty of payment, the great majority would prefer to be in network.

I applaud Trujillo for trying to address this complex issue, but there are common sense solutions that involve full transparency and disclosure by insurers and health care entities. However, I do not think that the government should be in the business of allowing insurance companies to unilaterally and arbitrarily set what physicians should receive for their services.

Rather, these charges ought to remain negotiated via a robust contracting process guided by fair market principals. Price setting, hasn’t proven to be workable within our state and I know our elected officials can search for better and more insightful solutions.

This story was originally published November 9, 2015 at 12:46 PM with the headline "Don’t blame doctors for unexpected bills."