I am writing this from an interesting perspective, as I can wear two hats: one as a high school and middle school teacher for more than 30 years and now in my second term as a state representative.
I might not be the first person you would expect to weigh in on an issue like surprise medical billing but I think it’s time. I have read about and know friends who have been hit by a surprise medical bill. I have recently seen this issue before the Legislature as well.
In a society that has such a tremendous healthcare system, one that offers amazing advances and access to some incredible doctors, the biggest challenges still seems to be understanding what things cost, and who should be paying for it.
Case in point, many folks who believe they have “good” health insurance may find themselves in need of care from a specialist or even a primary care physician who is not in the network, or they unfortunately find themselves in the emergency room. Recommendations for procedures or tests are made during these times, insurance information is provided, and the patient is treated. Then you go home and sometimes weeks or month’s later you get the unsettling bill in the mail indicating you are responsible for a larger than anticipated share of the costs.
Now this situation isn’t that much different from your standard schoolyard conflict — something I am quite familiar with. The patients, the ones receiving the bill, are innocent bystanders. They need to get pulled aside, out of the dispute, immediately. This is a disagreement between doctors and hospitals versus the insurance companies.
I believe the best way we’re going to solve this is with an independent, unbiased process. Several states, including New York and Texas, have already passed legislation with just such a process called Independent Dispute Resolution.
This process pulls patients out of the dispute and maintains balance between doctors and insurers. Importantly, it also doesn’t give the insurance industry the ability to set its own prices, which would have a big, harmful impact on doctors and hospitals.
I encourage Congress to take advice from this now middle school teacher or their own teacher’s voice deep in their own conscience. When it comes to surprise medical bills, get the innocent patients out of the way and set up a fair process that doesn’t let the insurance companies get their way. I believe Congress can get it done. In fact, I bet they can get it done in short order, so they don’t have to stay in during recess.
As a teacher of civics and history, I have always felt issues can be resolved with the right attitude and the appropriate directions. I am a great admirer of Sen. Susan Collins. As one of our state’s U.S. senators, she has proven time and again she can take on the tough issues and stand up for what is right for Mainers. I hope she can be a leader on this issue as well. I voted for it in the Maine Legislature and respectfully urge her to do so in Washington.
David Haggan of Hampden represents District 101 in the Maine House of Representatives. He is a middle school social studies teacher.