AOA, AMA should support balance billing


A reader argues in favor of removing the prohibition on balance billing,

The American Osteopathic Association (AOA) and the American Medical Association (AMA) constantly call for replacement of the sustainable growth rate (SGR), which would be helpful. But the AOA and AMA never say what they’d like it replaced with. It has been my impression that they would accept any government scheme for payment.

Instead, the AOA and AMA must push for removal of the prohibition on balance billing. This would allow physicians to bill patients for cost overruns. Medicine is the only profession or industry that is not permitted by contract or law to bill freely. Further, they should suggest that Medicare pay a percentage of what the physician billed, so that DOs and MDs can compete against each other on price. It is only in this way that a fair, competitive, and efficient market value will be determined, and not through the SGR, or reasonable and customary, or pay for performance nonsense.

There has not been a true free market in medicine since prior to the establishment of Medicare in 1965. It’s about time that all stakeholders, or as I call them, “strangleholders,” (government, hospitals, accountable care organizations, health insurance companies, big pharma, etc.) be forced out of the driver’s seat to allow patients to drive in the healthcare free market. After all, healthcare is entirely about the patient.

Craig Wax, DO

Mullica Hill, New Jersey

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