Health Care Reform and the No Surprises Act

health care

Health care is the effort to maintain or restore physical, mental, and emotional well-being through medical, social, educational, and other services. It includes the practice of medicine, dentistry, veterinary science, pharmacy, and nursing, as well as health management and public health. The term is often shortened to simply healthcare.

In the United States, healthcare is provided by a variety of government-funded or private insurers and businesses. These include the Department of Veterans Affairs, the Centers for Medicare and Medicaid Services, private insurance companies, the military’s TRICARE program, and many others.

While a majority of Americans agree that the quality of healthcare has improved over the years, many still report concerns about the cost of medical bills. In addition to the cost of insurance premiums and deductibles, people are worried about unexpected medical bills, long-term care costs, and even their ability to afford basic necessities.

A key concern is the lack of transparency in healthcare costs. Most consumers have little idea what their actual healthcare costs are, and even if they knew, they may be confused by the complexity of the billing process and the multiple layers of pricing. This is a major contributing factor to growing healthcare prices.

Another problem is that doctors often engage in defensive medicine, prescribing unnecessary tests and treatments out of fear of being sued. This adds up to expensive healthcare that could be avoided if doctors and patients focused more on preventive medicine.

The solution to these problems is not to make more money available for healthcare, but rather to allow healthcare to use free market principles. Government interference has skewed, cancelled or outright banned the ability of healthcare to take advantage of the efficiency and fairness that free markets bring to other consumer goods and services.

If the free marketplace was permitted to work its magic in healthcare, patients would benefit from outstanding quality and efficiency with lower costs, not just through the first-party transaction of choosing and paying for providers but also through competition between providers that drives innovation and new products. Patients could be smart, healthy, thrifty consumers who can choose the ecosystem that suits their individual needs best.

Ultimately, the best way to control healthcare costs is to reduce the need for it in the first place. This can be accomplished by focusing on prevention and tackling the societal factors that contribute to high-cost diseases.

The No Surprises Act and other legislation included in the Consolidated Appropriations Act of 2021 offer some help in this regard, but more reforms are needed to contain costs. For example, requiring a transparent price index to track healthcare costs and identify trends would be a valuable tool for consumers as they select the right healthcare plan for their needs. Likewise, state commissions that set prices, rather than merely regulating them, can also play a role. A good plan will provide a summary of benefits and a provider directory so that consumers can see all the costs, coverages, and limitations of each option.

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