$urprises Will Continue For Patients

The medical industry wins the Sacramento battle so everything stays the same  
$urprises Will Continue For Patients

Californians can “thank” their assembly members for making sure that, after undergoing a medical procedure, they can keep receiving unexpected surprise bills of hundreds and thousands of dollars. A sufficient number of legislators heed the lobbyists’ calls this week to stop a legislation that was trying to protect consumers.

According to a Consumers Union poll, at least one in four Californians have had the unpleasant surprise of an unexpected bill because one of the service providers is not part of the patient’s health network. The consumer thinks, for example, that in a medical procedure all costs are covered by the health plan because the doctor and the medical center are part of the network. However, it is possible that a participating radiologist or anesthetist are out of network, and the patient does not find out until he gets the bill. Furthermore, this money spent does not count in the deductible the patient normally pays.

The bill AB 533, by assemblyman Rob Bonta (D-Oakland), left the patient out of that scenario, establishing a negotiation system for doctors and companies to set an appropriate price for the service. That is not a simple process in a health system in which the prices of medical providers fluctuate without any logic, depending on who’s paying.

Lobbyists from different types of medical service providers flooded Sacramento with proposals and disagreements that achieved the desired effect: that everything stays the same. Since an agreement was not reached between the interests involved, 32 assembly members – both Democrats and Republicans – cowardly abstained from voting. Thus, they blocked the 41 votes needed for its approval, and left no trace of their support to the industry instead of the consumer.

Legislators preferred the current system of passing the bill on to the patient in order not to upset the insurance companies and the specialists. Some states, including Colorado, Maryland and New York, have corrected this problem. Our legislators think Californians do not deserve that.