Letters: Who should set prices for healthcare services?

Who should set prices for healthcare services?

Regarding the Sept. 2 editorial “An epidemic of financial toxicity,” I agree that charges by out-of-network providers are often unconscionable, but if we don’t allow them to set their own prices, who should set prices for them?

In one proposal being considered by the government right now, the prices would essentially be set by hospitals and insurers based on their agreements for in-network providers. Out-of-network providers are out-of-network specifically to avoid having these two groups negotiate their prices for them, and they shouldn’t be dragged into accepting fee schedules against their will.

The proposal to let insurers and providers sort out the price after the service has been performed is an even worse idea: It allows the purchaser to decide on a price for a product that has already been irretrievably delivered. That’s as if somebody stole my car and called me an hour later to tell me how much he’ll pay me for it. I shouldn’t expect much under those circumstances.

The only entity that can set prices prospectively for services is the government: This is the attraction of Medicare for All or something similar. If a doctor wants to see Medicare patients, they have to accept Medicare’s price for their services. The only decision the doctor has to make is whether or not to see Medicare patients. This has been an imperfect solution for patients already on Medicare, as it has made some services regrettably scarce (gerontologists) and others unnecessarily abundant (cataract surgeons), but it has solved the problems of price transparency and price-gouging.

AMA needs to realize value of Medicare for All, med students say

Last month, the American Medical Association announced its departure from the Partnership for America’s Health Care Future. While the AMA still does not support improved Medicare for All, this is an important step. Last year, the partnership spent $143 million lobbying against Medicare for All using decades-old scare  tactics like the fear of “socialized medicine,” rising costs and loss of consumer choice.

As future doctors, we know the evidence doesn’t support this. Several studies, including by the libertarian Mercatus Center, show Medicare for All will expand coverage while reducing overall health spending. Over 200 economists agree that Medicare for All would save money for most Americans. Unlike commercial or employment-based insurance, the programwould provide all medically necessary care free at the point of service, including dental, vision, reproductive and long-term care. Finally, a Medicare for All system would not significantly increase hospital use or lower doctors’ incomes.

Why does the AMA oppose Medicare for All? Today the association represents fewer than 25% of physicians and clings to policies that elevate the interests of for-profit corporations and private hospitals over those of patients. The AMA has fought against national health insurance as far back as the 1950s when it opposed Medicare and Medicaid.

That is why Students for a National Health Program co-led a demonstration at the AMA’s annual meeting in June. Our demands were clear: Leave the anti-single payer partnership and end your misguided opposition to single-payer.

While we applaud the AMA for leaving the partnership, we believe this is not enough. If the AMA is truly in favor of healthcare justice, it must support improved Medicare for All.

Robertha Barnes, Chris Cai, Diana Chang, Ashley Duhon and Michael Zingman (all are medical students and national board members of Students for a National Health Program)


, , , , , , ,