John Livingston News

Let’s Make Idaho Great Again

On July 13th of this year, I penned an editorial published in The Gem State Patriot entitled “Where are our Legislators on Health Care?” Several other Idaho physicians have asked the same question and opined in editorial pages around the State asking similar questions.

It has been obvious to many that the lobbyists in the health care industry the IMA/ IHA and various physician professional organizations including the American College of Surgeons and The American College of Physicians—both organizations that I once belonged to, are looking after their constituent members interests instead of patients—a situation not unlike the teacher’s unions that nationwide are placing their members needs ahead of students.

Yesterday patients received great news from the Trump administration. Under the new plan hospitals and insurers would be forced to disclose their secret negotiated rates for the 1st time. This is an issue many State legislatures have already addressed, and the Idaho legislature has refused to look into it. Trump administrators have said that hospitals will be required by 2021 to publish rates they negotiate with insurance carriers for services including drugs, facility fees and care by doctors who work for the facility.

This was one of the pillars of the 7 point plan that was outlined in an article published several months ago in both The Gem State Patriot and the Idaho Freedom Foundation Blog. There are two other areas that the legislature could address in the upcoming session that would benefit all Idahoans. Requiring all non-profits that receive over $100million of transfer patients to undergo a yearly outside signed partners audit to be made available to the people of Idaho via their legislature would give us a glimpse into the supply chain shenanigans and coding abuses that lead to inflating the cost of medical care.

One other back-office abuse of patients’ needs to be addressed by our legislature which results in Idaho patients being treated like criminals when they present to hospitals and providers for urgent or emergency care. When patients present for such treatment they are upon presentation given a single form to sign with one signature. This is, in fact, two separate contracts. The 1st contract gives the provider permission to treat the patient. The second contract requires the patient to pay 100% of whatever is charged.

Signing two contracts with one signature especially at a time of duress or stress should be against the law, but they need to sign either in the case of urgent or emergency care is also not required because all hospitals and provider networks are required by law to treat any patient presenting for urgent or emergency care under the 1986 EMTALA (Emergency Medical Treatment and Labor Act) that states that the provider has to treat and stabilize you irrespective of your ability to pay.

Our legislature should require all providers to so state upfront when providing services. They should also outlaw the requirement that patients be required to sign any agreement to pay prior to receiving services. If providers do make such requirements then government transfer payments including fees for service and facility fees and activation fees should be placed in jeopardy.

Medical bankruptcy is a growing problem in our country and State. The largest group leveraging such protection are not patients without insurance, but patients with insurance who cannot meet co-pays, deductibles and have ongoing year over year expenses. Tight insurance-provider networks and forcing patients to pay based on “Charge master listed prices”—another topic I will address in a couple of weeks, oftentimes forces patients into debt by being invoiced at rates 5-10 times higher than those negotiated between providers and carriers.

Now is the time for our legislature to take a page out of the Trump playbook and start protecting everyday people who already have insurance?

Let’s Make Idaho Great Again!

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