ANOTHER VIEWPOINT: Bill is a victory for health-care consumers


Anderson Herald Bulletin

Hoosier consumers scored an important victory with passage of a bill aimed at lowering health care prices in Indiana.

House Bill 1004 grew out of a recent study comparing Indiana’s hospital prices with those in 24 other states.

The study by the RAND Corp. found that Indiana’s prices were nearly 30% higher than the 25-state average and twice as high as those in neighboring Michigan. According to one estimate, just lowering Indiana’s hospital prices to the national average would save the average Hoosier family $2,600 a year.

Last summer, a group calling itself Hoosiers for Affordable Healthcare assembled a team of experts to study the issue, and that discussion produced the bill that has now passed both houses of the Indiana General Assembly.

The measure seeks to take the mystery out of what everyone will admit is a complicated process.

The legislation will require Indiana’s hospitals and insurance companies to provide patients with understandable estimates of what a procedure will cost, and it seeks to eliminate the so-called surprise medical bills that sometimes pop up when a patient goes in for a routine medical procedure.

As a result, a patient getting a mammogram at an in-network hospital would no longer find herself with a bill from an out-of-network radiologist. Patients would be exempt from such charges unless they had agreed to the higher cost at least five days in advance of the procedure.

The bill does not, however, say who would be responsible for the difference. It leaves that to be sorted out by the hospitals and insurance companies.

This change could benefit thousands of Hoosiers. A recent study in the Journal of American Medicine concluded that as many as 1 in 5 insurance customers winds up with the sort of unexpected bills the legislation is designed to prevent.

At one point, the measure also included a provision saying that patients undergoing treatment at a physician’s office or clinic could not be billed at the same rate as those receiving that treatment in a hospital.

The Senate dropped that language, though, after hospitals insisted the requirement might force them to eliminate services, reduce staff and even shut down hospitals.

There is much left to be done to resolve the issues brought to light in this debate, and reform advocates admit there is plenty of blame to go around. Hospitals, insurance companies, the government and employers all contribute to the problem.

Still, the passage of this bill is an important milestone. It’s a victory worth celebrating.

Send comments to [email protected].