The Jan. 13 editorial “Ending surprise medical billing” urged Congress to put an end to surprise medical billing. The National Alliance of Healthcare Purchaser Coalitions, of which I am president and chief executive, could not agree more.

Without federal legislation to stop surprise medical bills, millions of patients, employers and employees face $40 billion in unnecessary costs each year. Policymakers must fix the market loopholes that private equity firms and certain hospitals continue to exploit.

Congress was on the right track when the Senate Health, Education, Labor and Pensions Committee approved the Lower Health Care Costs Act. The bill would resolve surprise out-of-network charges fairly and protect patients from private equity firms’ predatory business practices, which take advantage of Americans at their most vulnerable. The Congressional Budget Office projected that this approach would save consumers and employers approximately $25 billion over 10 years.

The alternative approach — mandated federal arbitration — would leave patients bearing the cost and consequences of legal battles between health insurers and providers. It’s bad policy from start to finish. Recent experience in New York further confirms that patients and employers would face far higher premiums as a result of arbitration, undermining our ability to address the very problem Congress is trying to solve.

While it is vital for Congress to act quickly to end surprise medical billing, patients deserve a real solution. Congress should refuse to give private equity the upper hand against patients by passing legislation requiring fair, market-based rates for medical care.

Michael Thompson, Washington

As a physician, I think the suggested solutions to surprise medical billing are unnecessarily complicated. There are two simple remedies to this inexplicably long-standing problem. First, those subspecialists who practice within the hospital confines and, therefore, minister to a captive patient population (emergency room physicians, anesthesiologists, radiologists, neonatologists, etc.) must agree to contract with the same insurers as does the hospital in their hospital contractual agreements. Second, outside specialists who do not participate with a patient’s insurer but agree to “take call” as part of their hospital privilege arrangements must accept a fair, prenegotiated fee that the patient’s insurance company is willing to pay as mandated by the state’s insurance commission as part of the insurer’s right to do business in the state.

Patients should not have to confront these surprises and be taken advantage of under duress.

Jay Bernstein, Rockville

In her Jan. 14 Tuesday Opinion essay, “Surgeons can’t be permitted to act like muggers,” Cynthia Weber Cascio described receiving a high, unanticipated medical bill after an emergency appendectomy because the surgeon was not in her private insurer’s network. She was informed of the fee as she was being taken into surgery. The American College of Surgeons strongly agrees no patient should experience this. As the largest surgical association, we are dedicated to improving the care of surgical patients and to safeguarding standards to ensure the highest quality and best outcomes.

However, equating surgeons with muggers is unfair. Skilled surgeons are critical to treating acute issues such as the one the writer had and dedicated to treating these conditions without regard to the patient’s ability to pay.

We support efforts to prevent patients from receiving surprise medical bills. Patients should be kept out of disputes between insurers and physicians. And we continue to encourage legislation that protects patients from surprise medical bills, promotes access to appropriate medical care, and encourages insurers to negotiate in good faith with physicians to establish adequate provider networks and fair remuneration.

David B. Hoyt, Chicago

The writer is executive director of
the American College of Surgeons.