😮 Surprise billing and the two theories of legislating
House Ways and Means Committee Chairman Richard Neal has proposed a very Congress-like solution to the impasse over surprise billing legislation: punt.
Neal calls his proposal “negotiated rule-making,” which is a euphemism for moving the process out of the public eye and increasing its exposure to influence by special interests, all while allowing members of Congress to declare a win to their constituents on an issue everyone agrees needs fixing.
According to Robert King, writing in FierceHealthcare:
The negotiated rule-making process would require three agencies—the departments of Health and Human Services, Labor and the Treasury—to form a committee to identify standards for rates for surprise bills, according to the letter.
It would be up to the committee whether to add a dispute resolution and to define the parameters of that resolution process. The result would go through a public comment period.
This could be a compromise that interest groups could live with, since it provides all parties involved with the hope that they can still get their way. Only, instead of lobbying Congress for their preferred solution, provider groups and insurance companies will be able to lobby a triad of government administrators.
Two theories of legislating
That Congress would punt the issue to unelected administrators wouldn’t be the most surprising outcome in the world. What it does however is highlight two theories of legislating that get to the root of a lot of policymaking. The two theories can be generally summarized as:
Theory #1: Fix one thing at a time
Theory #2: Fix all the things at a time