When we debate the role of government in our health care, we often forget to discuss one of the most powerful institutions with a seat at the table: health insurers.
The barrage of hefty insurance premiums, confusing government benefits, and a red tape bonanza keep many of us dazed and confused when we examine our bills from our time at the doctor or dentist. Especially when we file an insurance claim. But it could get easier.
House Bill 3023 aims to simplify patients’ interactions with insurance companies specific to dental care, stipulating that insurers can only set dictate rates on procedures they cover, rather than your entire dental visit.
As has become common practice, dental insurers practice “downcoding” by classifying dental procedures differently in order to reimburse less or nothing at all to dental providers. Providing less total cost coverage means that those supplementary costs are passed onto dentists, who recoup that loss by raising their patient prices as a result. It’s a vicious circle.
This status quo has not happened by accident. It has been pieced together legislation by legislation, statute by statute, giving healthcare insurers a larger say in how prices are set, rather than allowing free contracts between providers and patients. This bill would help recalibrate that relationship to empower patients.
Some argue the dominant role of insurance companies in our care is part of the free market system. But a free market has stiff competition and equitable conditions where no party has undue privileges from government. However, as too many Oklahomans are aware, insurance plans have stacked the deck in their favor, and we pay the price.
That’s one reason why the Surgery Center of Oklahoma has achieved fame. It has become a renowned pioneer in “free market medicine” by cutting out all insurance and offering transparent prices for its services, drastically lowering costs for patients. No claim forms, no negotiations, and no extra paperwork. There’s a reason patients flock there.
We shouldn’t lose sight of what health insurance was meant for: managing risk and covering emergencies. Unfortunately, insurance has become central to our entire system, replacing risk with total coverage managed by a few politically connected health insurers with little competition.
While HB 3023 is a step in the right direction, more could be done to improve choice and lower costs for patients.
Encouraging dental membership programs, health savings accounts, and direct-to-consumer plans would be a start.
This would be similar to direct primary care doctors, who offer monthly subscriptions to patients and don’t accept insurance. Removing the insurance middleman means less bureaucracy, less red tape, and more time with patients. As a plus, prices are transparent and fair. That alone would provide better competition and prices for patients in need.
As patients, we are best served by a health care system that promotes transparency, innovation, and competition. If we can do that with one small step on dental care, imagine what we could do next.
Yaël Ossowski is deputy director of the Consumer Choice Center, a millennial consumer advocacy group.
Published in The Oklahoman.