OPINION:
In the past three weeks, the reality of the COVID-19 pandemic has forced everyone to adapt. For most of us, this is an inconvenience as we work from home and can’t go to the gym. But for the nation’s health care providers, their lives have been turned upside down.
Responding to the crushing new workload, physicians have sought to cancel elective surgeries and deemed many other patient visits “non-essential” to free up resources so they can fight the virus. The industry and the president have turned to telemedicine, a valuable, low-cost, low-risk tool. It redirects patients without in-person needs while reducing the burden on providers, and minimizes the risk that they could be exposed. Everyone is doing their part to adapt.
Except for health insurance companies — which just want to try to adapt the crisis to their profit margins.
Every other industry is stepping up to alleviate the pain our country will inevitably face in the coming weeks and months. Yet, Big Insurance companies are hell bent on price-gouging patients so they can boost their already record profits.
As The Guardian reported, insurance companies are slow-walking approval from healthy, hospitalized patients — many of whom should have been released — because it is more profitable for them. Typically, waiting for authorization for next steps can take a few days, but with a life-threatening shortage of hospital beds now, the insurance companies’ red tape has “dire consequences.”
With private insurance standing in their way, some doctors are trying circumvent the bureaucracy entirely. Last week, 400 new health providers signed onto telemedicine company Beam Health Group, where doctors are setting their own rates to make the transition faster. (Free-market economics at work, hurrah!) Meanwhile, UnitedHealthcare is choosing this crisis to cut ties with physician-staffing firm Mednax over a pricing squabble.
Perhaps the most egregious way the insurance company industrial complex is exploiting the coronavirus is using it as an excuse to jam price controls into congressional legislation.
Insurance companies and their minions in Congress — on both sides — have long wanted to exert price controls into our free-market health care system, specifically using the phenomenon of surprise medical bills (SMBs).
Insured patients get hit with SMBs when they receive treatment from an out-of-network provider during an otherwise visit, like if insurance covers surgery but not a two-minute conversation with an out-of-network nurse practitioner. SMBs are awful for patients and providers, but insurance companies love them because then they don’t have to pay for anything.
Big Insurance’s current weapon of choice is bills introduced by Sen. Lamar Alexander, Tennessee Republican, and Rep. Frank Pallone, New Jersey Democrat, that would give the government the power to institute price controls in the face of SMBs. Both of these bills failed last year, as did the effort to sneak them into the recent stimulus package. But they’ll be back.
Price controls might sound benevolent, because the people who carry that flag are just want to help sick people, but the only beneficiaries of price controls are insurance companies. When price controls are applied to health care, patients have to buy expensive plans with high deductibles and weak coverage. This is why the health insurance industrial complex has been making record profits under Obamacare.
At the White House, the Big Insurance lobby promised President Trump they would suspend SMBs to coronavirus patients — but quickly admitted that many such patients will get hit with SMBs on creatively assigned, COVID-adjacent charges. The Association of Health Insurance Plans confirmed that out-of-pocket expenses for the treatment would not be waived, and a patient could get charged for pneumonia, rather than COVID itself.
So, insurance companies are manufacturing a problem that they can fix with legislation that will make them richer. This is like any movie where a shadowy government agency carries out a false flag mission to spark a conflict — so tell Captain America, Ethan Hunt and James Bond they need to start fighting Big Insurance instead of rogue nations.
The coronavirus has brought life on Planet Earth to a screeching halt. For our health care providers, that means an enormous amount of exhaustion, sacrifice and risk as they try to keep the country going from worse to worst. We all hope to come through this crisis stronger, but insurance companies are doing their best to make sure they come through it richer — all while selling the myth that price controls are what the doctor ordered.
• Jared Whitley has worked in the White House, the Senate and in the defense industry.
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