Surprise Medical Billing connected to health insurance company profits

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To the Editor;

Even as health insurance companies report record profits, I regularly read about the growing crisis of Surprise Medical Billing (SMB). It seems implausible that these two trends are somehow unrelated. SMB occurs when health insurers won’t pay for medical care and, instead, those costs are shunted off to patients who can scarcely afford them. So are the insurance companies pocketing more profits at the expense of patients they claim to insure? It would certainly appear so.


The SMB crisis is now so pervasive that Congress is considering various measures to resolve the issue. Some “solutions” advanced by the insurance companies would wring even more money out of patients, doctors and hospitals. Insurers want to set benchmark reimbursement rates for out-of-network care far below the actual costs of delivering that care. Why? Because they could then reduce their provider networks, consistently pay the below-market rate, and pocket the difference as pure profit. As they saying goes, “you can’t make this stuff up.”


Apparently without shame, the insurers even advanced these proposals in broad daylight. But they’re canny enough to understand the public outcry if these measures were fully and publicly debated under CSPAN’s bright lights. So rather than risk the public and political blowback, they’re trying to quietly slip this legislation into a last minute, end-of-the-year appropriations bill, desperately hoping it gets little or no public attention. I would be shocked if this weren’t playing so true to form.  


However, I hope, U.S. Sen. Collins will continue the thoughtful leadership she has always exhibited. I am sure she is as shocked over the fallout on this issue and the effect on many Maine citizens. Because this truly is an outrage. Our health insurance system is wildly out-of-whack. The insurance companies have far too much control and now they’re trying to run the tables. If they’re successful, rural hospitals like ours here in Piscataquis County are likely to close; physicians would hang up their stethoscopes; and patients who need care would suffer the most, both medically and financially.


Please stop this rush to the bottom. And please especially stop it from happening in the dead of night.  The best medicine for the insurance companies right now is the clean, disinfecting light of a full, public  Congressional debate.


Jonathan Seavey



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