Thread by @A4Horg

The only way to solve #surprisemedicalbills is with a #fairIDR. But we need to get to the crux of this #SMB issue.

☑️ Everyone agrees to take #patients out of the dispute b/w #insurer & #doctor.
☑️ Everyone agrees to let the 2 parties negotiate the bills if the initial...

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payment is deemed to be unacceptable.
☑️ Everyone agrees that there must be a fall back to a neutral third party (i.e., an #IDR entity).

⭐️BUT, what is disputed is whether this IDR will be a fair process where both sides can equally make their case for what is the most...

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appropriate amount for that non-contracted service OR whether the IDR will be rigged and so unfair that the insurer will always win the dispute.

Many IDR proposals, sadly, are unfair, pointing the IDR to primarily consider the contracted rates #health insurers make up...

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& fully control. This prohibits doctors & #hospitals from introducing #data regarding how they & similar doctors value & have valued these services, & how insurers have themselves valued & paid for these out-of-network services in the past.

A fair IDR process preserves...

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what little negotiating influence doctors still have w/ insurers & allows a balance of market forces to work. These forces are necessary for proper allocation of services within the health system. The insurers’ preferred IDR would expand on their already record #profits...

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and destroy the independent #healthcare sector completely. Then, the gov't would essentially create a system of corporate #socialism — a system where insurers can pay whatever they want.

#Congress #unpaidinsurerbills #medicine #medtwitter

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