Schwarzenegger's Balance Billing Ban Letter
As an emergency physician in California, I am VERY concerned about the executive order to ban balance billing. It is amazingly obvious that those that have proposed these types of legislation are aligned with insurance companies and their lobbyists. Anyone that sees what goes on on the "front lines" on emergency departments knows how ill our system has become. Hospitals and clinics bill for more than their services cost so that when they finally get reimbursed by the insurance companies or MediCal, they come close to even covering operating costs! Our services are constantly shortchanged and some offices need to hire full time staff just to argue with insurance representatives with minimal or no medical training that refuse claims on testing that is deemed necessary by physicians. It is amazing that current legislation allows patient care to become limited with these types of practices.
Although balance billing sounds like it is unfair to patients when they get an additional bill, it is actually unfair to physicians and hospitals who are not getting reimbursed enough to cover costs, let alone make a living! Being able to bill a patient for what an insurance company does not wish to pay for keeps the patient in the loop as a self advocate. If they get this bill, they can protest it and eventually the insurance company is forced to pay what they are contracted to pay rather than cheating the hospitals and shirking their responsibilities to patients.
By taking away our ability to do this, you give insurance companies an open door to take advantage of already struggling healthcare providers and hospitals by paying out whatever they want
The patient needs to know that they are being cheated by their insurance company so they can stand up for themselves and force the company to fulfill their contractual obligation. In my opinion, insurance companies should all be non-profit, then we take away the great motivator - money. It is clear that insurance companies have a great deal of money and lobbying power to get these kinds of measures passed through. We, as physicians, healthcare providers, clinics and hospitals, do not have this kind of money to sink into convincing politicians to do what is in our interests. We only ask that as a politician, you do what is in the patients' best interests, not the insurance companies.
Thank you for reading, I am an idealistic, enthusiastic environmentalist and ER doctor and have many perspectives on healthcare and energy policy that I would be happy to share. Please let me know if I can be of any assistance to the state.
Clint Slaughter, M.D.