I find Catherine Nadeau’s letter of Oct. 25 (“How hospital consolidation drives up costs in Maine”) curious.
In it, she criticizes certain terms that she alleges hospitals negotiate into their contracts with insurance companies. She asserts that hospitals negotiate “anticompetitive contracts that force insurers to include every facility in that hospitals’ system in their network. What this means is that hospitals force patients to use their facilities, providers, or services even when there are more affordable or higher quality options available. By limiting consumer choice in this way, hospitals are able to artificially increase their own bottom lines at consumers’ expense.” The illogic of this argument is astounding.
First, how is requiring carriers to include more hospitals “anticompetitive?” Anti-competitive behavior tends to reduce choices for patients, not expand them. Forcing carriers to include all hospitals in a network expands choices for patients on where to receive care.
Second, inclusion of hospitals in a carrier’s network does not, as Nadeau alleges, “force patients to use their facilities.” Just because a hospital, or any provider for that matter, is in-network does not “force” any patient to use it. Including as many hospitals or other providers as possible in-network is a good thing because it gives the patient more choices and thereby more control. Choices enhance competition.
What is Nadeau’s solution to this non-problem? “Legislators should allow health plans to create provider networks that best fit their customers’ needs and budgets.” She wants your health plan to decide which providers you can see. This policy would “force” patients to use certain providers — by taking choices away.
We should applaud hospitals that fight to expand networks and give enrollees more choices. We should not incentivize insurance companies to pick your provider for you. Nadeau seems to have her policy prescription exactly backwards.
Jeffrey Austin
vice president, Government Affairs & Communications
Maine Hospital Association
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