A major insurer, Anthem, dropped its plan to reduce payments for anesthesia services due to widespread criticism and misinformation. However, experts say this decision does not address the root issue of high healthcare costs in the US.
Anthem’s initial plan aimed to discourage overbilling by implementing maximum time limits for procedures. This would have allowed anesthesiologists to appeal for higher payment if operations went longer than medically necessary. However, critics, including some lawmakers, claimed that this policy would lead to surprise medical bills for patients.
Experts argue that the burden of cost control should fall on participating anesthesiologists, not patients. “Providers – not insurance companies – are the primary drivers of high health care costs,” says Christopher Garmon, associate professor at the University of Missouri-Kansas City’s Henry W. Bloch School of Management.
The US spends significantly more on healthcare than other developed countries, largely due to higher payments to hospitals and physicians. In 2021, Americans spent nearly twice as much per capita on healthcare than other wealthy nations. High physician salaries, including anesthesiologists, contribute to this disparity.
Forcing down payment rates for anesthesiologists could help reduce healthcare costs while treating more patients. However, the most effective solution would be a comprehensive system of public cost controls and insurance provision. Private insurers playing a harder bargain with expensive doctors and hospitals can also drive changes in the sector.
Instead of demonizing insurers, we should focus on addressing the root causes of high healthcare costs in America – the high rates charged by providers such as hospitals, physicians, and drug companies.
Source: https://www.vox.com/policy/390031/anthem-blue-cross-blue-shield-anesthesia-limits-insurance