For a preview of the fight to come over improving anything in our healthcare system, look no further than the fight the providers—hospitals and some doctors’ groups—are waging against fixing one basic, big problem: surprise billing when people with insurance receive care from providers or at facilities that aren't in their insurance networks.
There's legislation in both the House and the Senate to fix the problem, and the efforts are bipartisan. One option lawmakers are looking at is benchmarking payments, that is, establishing a payment based on the average, or benchmark, payment for a procedure based on what other doctors are charging for it in the area and making that the limit for what out-of-network providers could bill patients. Everybody—employers, insurance companies—likes that, except doctors, especially specialists. They want arbitration, in which "both the insurer and provider would propose an amount to an independent third party, who would pick one of the two prices. The loser then pays the costs of the arbitration."
There had been hopes that the Senate would pass its version before the August recess, but lobbyists managed to stop that from happening. Now it looks like the American Hospital Association thinks it has killed current proposals.
Meanwhile, a mystery group calling itself Doctor Patient Unity has spent $13 million in more than 20 states just since July on an ad campaign fighting the legislation. That's along with the almost $10.2 million the AHA has spent on lobbying so far in 2019, and the $11.5 million the American Medical Association has spent this year. The Congressional Budget Office says that one of Senate's bills could lower premiums by 1% across the board, which is apparently a bridge too far for providers.
All of which tells you just how hard these groups are going to fight any change at all to the existing system, even tweaks to the Affordable Care Act or the addition of a public option to give people a Medicare-like choice. If they're willing to fight this hard lining up on the wrong side of public opinion on this, a serious but relatively limited issue, they'll go all out fighting Medicare for All.
Which argues for Democrats to also go just as maximalist in fighting for Medicare for All. Take the fight head on and do what Democrats didn't do in 2010—make them the enemy standing in the way of very popular universal, affordable health care.