New Proposal in Congress Around Surprise Billing Could Drive Doctors Out of South Dakota
We don’t usually think of health care as a market. When our child is sick, we aren’t contemplating supply and demand—we just want them to get better. But capitalist forces still apply to health care. This means bad policies like price controls can cause health care shortages here in America as easily as they do food shortages in Venezuela.
Unfortunately, some of our federal elected leaders are acting like health care is immune to such impacts. They want to set government-mandated rates for much of the care doctors and other medical professionals deliver.
It’s a crazy idea born from good intentions. These lawmakers are focused on cutting down on surprise medical bills some patients get after receiving care they didn’t realize was outside their health plan network. This is a real problem in metropolitan areas. In New Jersey, for instance, nearly one in three medical emergencies results in an unexpected bill, according to a Kaiser Family Foundation analysis. We do better here in South Dakota—our number is just 4 percent.
We don’t have a bad case of the surprise billing “disease” but the “cure” proposed by Congress would do the greatest damage in rural parts of the country like ours. The vast majority of South Dakota counties already face severe doctor shortages. We aren’t adding nurses in adequate numbers to replace those retiring. And although South Dakota invests more in salaries than most other states, we’re struggling to build a sufficient health care workforce.
“If government price fixing adds to these challenges, we will be in dire straits indeed.”
Sadly, the most vulnerable among us will bear the greatest burden. Rural areas have aging populations with extensive health care needs. Moreover, one in four U.S. military veterans lives in a rural community. With only three VA centers and a handful of clinics across our state, many former service members rely on local doctors for everything from checkups to PTSD treatment.
The veterans I work with often deal with daily pain because of injuries they sustained while serving our country. Similarly, my senior patients worked hard and raised families but now suffer various aches, degenerative disease, and other painful problems. These deserving people—and all patients—need access to quality care, including safe, effective pain management. But fewer doctors will be here to offer it if price controls are in place.
Have no doubt, the system-wide consequences of the surprise billing legislation would be life-threatening. With more doctor shortages, a person suffering depression may be unable to get psychiatric help before taking his own life. A woman with a breast lump might not get treated before her disease spreads.
Even one unnecessary tragedy would be an unacceptable outcome of this blanket pricing policy conceived in Washington to address a problem South Dakota has largely fixed. Price controls don’t work for our state, and our leaders in Congress should say “no.”
Dr. William Cohen