Avik Roy: Chuck Schumer Blocks Bipartisan ‘Surprise Billing’ Healthcare Reform to Placate His Corporate Donors

The Associated Press
The Associated Press

Sen. Chuck Schumer’s (D-NY) opposition to S. 1895, proposed legislation titled the Lower Health Care Costs Act, comes after a political action committee (PAC) supporting him received a million-dollar donation from a New York-based hospital lobby, noted Avik Roy, policy editor at Forbes Media, in a Monday interview on SiriusXM’s Breitbart News Tonight with hosts Rebecca Mansour and Joel Pollak.

Mansour invited Roy’s comments on the Lower Health Care Costs Act drafted by the Senate Committee on Health, Education, Labor, and Pensions.

“The surprise billing legislation — the original bill which came out of the Senate committee, which is run by Republican Lamar Alexander — that bill was very good,” said Roy. “The newer versions of this bill — after furious lobbying by hospitals and doctors, particularly the kinds of doctors who engage in the practice of surprise billing — got watered down, so it’s not as good as it was before, but it’s still okay. I’d say it’s still better than the status quo, but even that bill is being blocked by Chuck Schumer, who received a million-dollar donation to his super PAC from the local hospital lobby, so he’s fighting this tooth and nail.”


Senate Majority PAC, a partisan Democrat political action committee, received a $1,000,000 donation from the Greater New York Hospital Association Management on April 12, according to financial disclosures aggregated by Open Secrets.

Roy remarked, “By the way, that’s not the only thing in this package related to health care. The bill that’s being considered by Congress also, reportedly, will repeal the Cadillac tax, which is one of the few good things in Obamacare that tries to tackle the high cost of employer-sponsored insurance, and a bunch of other things. Basically, what’s going on here is the lobbyists are winning and the patients are losing.”

“When the government is paying for something, what the government is paying is a subsidy,” Roy stated. “The government is subsidizing the purchase of prescription drugs by seniors, something they didn’t used to do, in most part, until 2002, when the Medicare prescription drug benefit was passed. You may remember that conservatives at that time complained about the Medicare prescription drug benefit, but that was a big expansion of big government. That was arguably one of the things that helped create the Tea Party … the outrage over the fact that the government was going to be spending our money, expanding the deficit, to pay for subsidized prescription drugs for seniors.”

With the Prescription Drug Pricing Act, the Senate Finance Committee initially proposed limiting annual increases in federal government spending on prescription drug benefits for seniors to rates of inflation as per the consumer price index, explained Roy.

“What the bill that the Senate Finance Committee produced has done is, they said, ‘Okay, we’re going to try to reduce that federal spending by saying we’re going to grow that federal spending at inflation. So what we’re doing to subsidize drugs for seniors, that’s going to grow at consumer inflation,’ instead of 11 or 12 percent, which is what the drug companies want,” Roy said. “The drug companies want those subsidies to grow at 10 or 12 percent per year. And so the bill simply says the subsidies will grow at inflation, which is good. That’s entitlement reform, but of course, that means less money subsidizing the drug industry.”

Roy continued, “This is the absurdity of the Republican Party, now, where if you reduce taxpayer-funded subsidies for multinational corporations, you’re a socialist, but if you try to help struggling working class Americans afford health care, you’re a socialist. It’s like, basically, the Republican Party is against affordable health care for lower-income people and for subsidizing multinational corporations. Does anyone wonder, therefore, why Republicans are increasingly unpopular on the issue of health care?”

Patients are vulnerable to “surprise billing” when receiving treatments while impaired or unconscious, explained Roy.

“Republicans have routinely said … ‘We don’t want anyone to get between you and your doctor,'” Roy stated. “Well, right now, there are a lot of things that get between you and your doctor, and sometimes it’s the doctors. There are doctors out there — not all doctors, not even maybe most doctors — but there are doctors who take advantage of the system that we have to rip off patients.  Because if you are the kind of doctor that treats patients when they’re unconscious, when they’ve been hit by a bus, or they’re undergoing surgery and you’re kind of helping out the surgeon, but that patient hasn’t chosen you as the anesthesiologist or the emergency medicine doctor, those are the doctors that are charging the biggest markups, because they know the patient has no role in choosing them, and if the insurer says, ‘No, we’re not going to pay that bill because you’re overcharging,’ then it’s the insurer who gets blamed, not the doctor, because the insurer seems like the mean entity that’s not paying for the care you needed when you were in [an] emergency. [Insurers are] basically … forced in PR sense to pay for this stuff. These particular kinds of doctors [have been] getting away with murder for a long time.”

Roy went on, “Some doctors are so unscrupulous, saying, ‘You know what? Even though you’re paying us five times what Medicare pays, or ten times what Medicare pays, that’s not good enough for us. We want 20 times what Medicare pays,’ and they go out of network. Because at that point, the insurer says, ‘Enough is enough. We’re not going to accept that,’ the patient gets a surprise bill in the mail.”

“The University of Virginia, a university hospital filled with left-wing academics, is running around suing patients who didn’t pay the bill that were these out-of-network surprise bills,” Roy shared. “There are certain hospitals for whom this is a business model. ‘We’re going to do a lot of things out of network, and then bill the patients for it, and then write off what we don’t collect as bad debt and appeal to the government to bail us out for a bad debt.'”

The addition of arbitration measures within newer versions of the aforementioned proposed legislation as a means of dispute resolution between patients, insurers, and healthcare providers over billing amounts to a watering down of patient protections from predatory “surprise billing,” determined Roy.

“What the original legislation that came out of the Senate did is it said, ‘If you are an out-of-network doctor … you have to accept the median in-network market rate that’s been negotiated between insurers and doctors like you for that service,’ and that was what came out of the Senate,” Roy explained. “But of course the doctors — the doctors in Congress, and the doctors’ lobby and the hospital lobbies and the private equity lobbies behind some of these expensive doctors’ groups — they furiously, every day, ran relentless campaigns, running ads, obviously lobbying members of Congress to try to water it down, and the technique they’re using to water it down is called arbitration.”

Roy concluded, “The new bill creates this arbitration procedure that’s basically designed to increase to cost of care for patients, and you wouldn’t see it, because of course the bill is paid by the insurer. By law, Congress would force the insurer to pay the bill. But because the prices would be higher for all the services, you’d see that in the form of higher premiums, higher deductibles, and higher co-pays, because that’s what happens when health care gets more expensive: your deductibles go up and your premiums go up, and your paycheck goes down.”

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Follow Robert Kraychik on Twitter @rkraychik.


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