This is a copy of the Op-Ed that has been submitted to The Union Leader today. I have also submitted a similar letter to the editor in the Laconia Daily Sun, Citizen of Laconia, Fosters Daily Democrat and Concord Monitor.

The primary sponsor of NH Senate Bill 505, establishing a commission to set rates at private hospitals in NH is State Senate Majority Leader Maggie Hassan (D – Exeter). This bill creates a “Health Services Cost Review Commission” to “review and approve or disapprove hospital rates and rate schedules” and is to be funded by an assessment (see Tax) levied on hospital revenues.

This commission has the ability to determine how large it becomes and is given its own authority to assess and collect a tax on hospital income, identified as “administrative assessment” on “net operating revenues.” Let me repeat that, this commission has the ability to determine it’s own size, how many employees it will have, how much money it needs to operate and to collect that money directly from the hospitals in without legislative oversight. This sounds dangerous to me.

Sen. Hassan, in her press release identifies “Maryland and other states with similar commissions study all the factors that go into hospital costs – including things like the population of Medicaid patients, uncompensated care, severity of illnesses and cost of living in a given region.” What she fails to mention is that Maryland is the ONLY state with a commission like this and that they have a special federal waiver that allows them to set all rates at hospitals including what the state must pay in Medicaid and Medicare reimbursements. Why doesn’t her bill provide the authority to force NH to pay its fair share of the Medicaid and Medicare reimbursements?

One of the driving factors in the disparity charged patients is the fact that NH has one of the lowest reimbursement rates for Medicaid and Medicare in the nation. This disparity has to be made up elsewhere. Hospitals have negotiated reimbursement rates for different procedures from the insurance companies and Sen. Hassan’s point is that an uninsured person receives a bill for the full amount of the cost but misses the point that what the uninsured actually pays is reduced more than the discounted rates insurance companies pay.