The Senate came up with a list of reforms that highlighted what is currently wrong; nightmarish gaming of the system robbing Americans of their hard earned money.
Remember, the cost, the maze of procedures, and the constant oversight would not exist under universal health care. Think of the savings:
The Senate health committee released its draft legislation to tackle healthcare costs, with provisions that read like a road map of how hospitals and insurers use contracts to dominate their competitors, consolidate their business and keep patients in the dark; mend loopholes exploited by hospitals, insurers, and manufacturers; and cut some fat out of the healthcare industry through simple reforms.
1. The ban on surprise medical bills.
2. Force air ambulances to separate out medical charges from the transport costs in the bills they send to patients and health plans.
3. Mandate patients receive their full bill within 30 business days. If the bill comes later, the patients wouldn't be obligated to pay.
4. Hospitals, physicians and health insurers would have to give patients "good-faith" estimates of their out-of-pocket costs within 48 hours of a request.
5. Insurers' provider directories would have to be kept up to date.
6. Provisions would correct hospital and insurer manipulations of contracts, which play a big role in setting the prices patients must pay and determining where they have to go for care.
7. A ban on gag clauses that some hospitals include in their insurer contracts. Hospitals could no longer prevent patients or any other party from seeing all hospitals' cost and quality data.
8. Put a stop to "anti-tiering" or "anti-steering," where hospitals through their insurance contracts keep patients from choosing treatment at competing health systems.
9. There would be no more "all-or-nothing" clauses where hospitals force insurers to contract with all their facilities by saying if they don't contract with all of them they can't contract with any.
10. Hospitals could also no longer hide certain anti-competitive contract features from the employer plans they contract with.
11. The Government Accountability Office would be mandated to investigate profit-sharing between hospitals, contract management groups, specialty physicians and specialty physician contractors.
12. Dominant health plans would no longer be allowed to use their market leverage to hold local hospitals and physicians hostage for the best payment rates, to the detriment of competing companies.
13. Pharmacy benefit managers would have to send quarterly reports on the costs, fees and rebates to the employer plans they contract with.
14. Spread pricing of the rebates PBMs collect from manufacturers would be banned.
15. PBMs could no longer profit off health plans or patients by demanding higher drug prices than they paid the manufacturers, and they would have to pass along 100% of the manufacturer rebates or discounts to their plan sponsor.
16. Drug pricing, to stop manufacturer gaming of exclusivity periods and boosts for more generics and biologics.
17. Public health by seeking to boost vaccination rates.
18. Check the U.S.'s dismal maternal mortality rates. It also incorporates a number of health IT provisions.
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