I’d like to express my admiration for Rep. Henry Beck’s guidance in the Maine House during the complex debate over medical price disclosure. I served with Rep. Beck, D-Waterville, on the Legislature’s insurance committee.

Last session, the House passed a good proposal by Beck requiring commercial health insurers to disclose average prices paid for medical procedures within their treatment networks. It also toughened rules for answering patient inquiries about prices. This would have been a big step forward for medical price transparency.

However, the Senate passed a more extreme proposal mandating commercial health insurers to pay cash bonuses to patients who obtained cheaper than average medical services, wherever found, without quality safeguards. This was a bad idea.

Maine law lets insurers voluntarily award patient bonuses and incentives, but such plans are not mandatory.

Evidence from insurers showed such bonuses could be expensive to administer, with perverse incentives and little reduction in premiums. It would disrupt negotiated insurer medical networks, disregard quality monitoring, and complicate rate-making.

Rural hospitals such as Redington Fairview General Hospital in Skowhegan would be hurt by a mandatory bonus law. They must also serve Medicaid, Medicare and uninsured patients at a loss, and would face unfair competition and aggressive advertising from for-profit specialty clinics, who have no obligation to take all comers, and who would skim off revenues from the fully insured that rural hospitals use to balance their books.


To protect rural hospitals, the Maine Hospital Association vigorously opposed the mandatory patient bonus scheme. Rural Mainers depend on access to their local hospitals.

In the end, neither version passed. Unfortunately, Beck’s practical step forward for medical price transparency was sacrificed to the Senate’s stubborn adherence to the ideological patient bonus idea. The future of rural hospitals may be at stake. Stay tuned.

Ralph Tucker


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