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You are here: Experts > Homework Help > Current Events: U.S. > Current Events: U.S. > Negotiating health care provider rates vs. fixed rates
Current Events: U.S. - Negotiating health care provider rates vs. fixed rates
Expert: Dennis - 10/30/2009
Question
I'm unclear about the implications of the current prospective provider compensation compromise on the "public option" health care reform plan. I understand the compromise would require the government to negotiate rates individually with providers instead of imposing rates, such as Medicare + 5%. However, would providers in either case not be able to opt out? I understand that the more left-leaning folks (I'm one!) feel that allowing negotiation would give the providers too much power -- but I don't see how. Furthermore, would not the ability to negotiate rates serve to keep providers in the system in areas where costs are especially high or revenues especially low? Why is the left against it?
Answer
Actually I think it's too early to deal with each bill's specifics. "Opting" out varies from the House to the Senate. The States may opt out, the individual may opt out, the provider may opt out, but there are different penalties in each bill. For instance, in the most recent House version, a provider may op-out and accept private funds from a patient, but then the provider is barred from receiving any money from the government for the next two years
Likewise, the individual who opts-out receives no medical coverage (including medicare), for two years. Negotiations with providers may be on a State by State basis instead of a provider by provider basis. Originally, the negotiation idea is what brought the AMA on board. They believed that "negotiating" vs. fixed rates would be to their benefit. Apparently, they do not not realize that the year after the program starts, the government can go back to fixed rates.
Until specifics are agreed to in the House/Senate conference committee, it really is much like tilting at windmills. I'd stick with the "overview" of ideas until all the amendments to all the bills are done.
Do you want an additional Trillion dollar deficit added to our economy, which will result in rationed services, higher taxes and reduced benefits? I don't. Hopefully if Republicans win in New Jersey and Virginia on Tuesday, and the Conservative candidate wins in New York, the mopes in Congress will be so terrified about doing anything, that they will settle on an extremely watered-down version of a "health care bill" (like allowing insurance companies to compete with each other across State lines), they'll call it a victory, and go and hide for the next two years hoping the voters will forget everything.
The problem with your question is that it can change next week, depending what happens in various committees. The definition of "negotiating," "fines," "opting-out," "providers," can change.
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