The recent editorial about surprise bills blamed physicians for patients receiving outrageous bills for simply seeking care. The American Medical Association has called for federal legislation to immediately protect patients facing surprise bills while encouraging physicians and insurers to negotiate reasonable contracts that prevent out-of-network billing in the long run.
Legislation approved by the House Energy and Commerce Committee, once championed by insurers, has now lost industry support because of an amendment providing for “baseball style” arbitration, allowing a neutral umpire to determine fair payment when an out-of-network physician and the patient’s insurer can’t agree.
This does not, as the editorial suggested, require a huge bureaucratic response. For instance, look at New York state, which has such an approach. In 2018, only 849 of 7.5 million surprise billing cases (0.0113 percent) went to arbitration.
This shows that encouraging fair claims and payments discourages entering the process in the first place. Of the 849 cases, final decisions were nearly evenly split. Meanwhile, insurance premiums in New York have grown slower than in the rest of the nation, and out-of-network bills have declined 34 percent. Independent dispute resolution is solving surprise billing problems without significantly raising patient costs.
As physicians, we know insurers are narrowing networks, and patients may struggle to find in-network care, especially when it comes to hospital stays. That’s why we are asking for a solution that takes patients out of the middle and urges doctors and insurers to negotiate contracts.
DR. GERALD E. HARMON
Member, AMA Board of Trustees
Fix teacher shortage
South Carolina has a crisis-level teacher shortage. According to the education advocacy group SC for Ed, there were about 900 vacant teaching positions statewide at the start of the school year.
When a report on teacher hiring is issued by the S.C. Department of Education, I suspect the department will pivot from the alarming vacancy numbers and focus on happy talk about “innovative” strategies being used to fill positions.
The strategy likely to receive the most hype is alternative certification, which allows people with college degrees to become teachers without formal preparation or a student-teaching experience.
While alternative certification certainly has a place, it will not generate the large and sustained pool of qualified candidates needed for our classrooms.
Unfortunately, our state leaders are failing to address the fundamental questions of why so many good teachers leave the profession and why so few college students want to teach.
The real solution is to make the profession more attractive. This means better pay, smaller class sizes, adequate resources for struggling students, dialing back the state’s obsession with “bubble” tests and just plain professional respect.
Research has shown the single most important factor in student learning is an effective teacher. Rebuilding the teaching profession will ultimately fix the shortage and also fix a lot of other nagging education problems.
Hunter Hill Road
Dry clothes outside
One of the 10 things a person can do to address climate change is to reduce the amount of electricity used at home. Try drying clothes outside.
Could anyone please tell me why the majority of HOAs in the area prohibit drying clothes in backyards? In the United Kingdom, most people use a rotary umbrella-type hanger, which is unobtrusive and can be taken down when not in use. Why can’t we use them here and make a small difference in climate change?
Trees and power lines
Trees and power lines don’t seem compatible. The choice is to massacre our beloved trees to prevent power disruption or spend a fortune to bury the lines and save the trees.
Unfortunately, buried power lines are susceptible to flooding and saltwater intrusion, which can cause power outages and other problems. Buried power lines also take longer to repair and at a greater expense.
There is a third choice. Harden the current system by replacing shorter, and weaker wooden poles with taller, stronger reinforced concrete poles. That would enable the power lines to be strung above trees.
The power industry now has stronger, more hurricane-resilient power lines that can be installed on these stronger, taller poles. If we did this in the most wind-prone and bucolic areas, it would be a big step toward mitigating power loss as well as preserving our gorgeous and historic tree canopies.
TOM DI FIGLIO
Duck Hawk Retreat