The free market has the power to provide patients with high-quality, affordable healthcare. A system free of burdensome government regulations puts patients in control of their health plans, it allows them to make decisions about their own care in close consultation with their doctors, and it gives them more options. When the free market thrives, patients gain.
Big insurance companies have done everything in their power to manipulate the market and rig the healthcare system in their favor. When they control the market, they stand to gain—and, unfortunately, doctors and patients both lose. During the COVID-19 pandemic, when most of the U.S. healthcare system approached financial collapse, insurers emerged as the big winners and collected record profits.
One way big insurers have rigged the system in their favor for years is by buying up medical practices, pharmacies, and other parts of the healthcare delivery system. Vision and dental plans have flown under the radar while engaging in many of the same practices. In the vision coverage market, two large, vertically integrated plans cover two-thirds of all Americans with supplemental insurance.
These plans wield massive leverage over both doctors and patients. They force doctors to accept hugely unfavorable plan-provider agreements. They dictate to doctors the prices they charge for services and materials not covered. They force doctors to use certain labs and steer patients to certain products.
Why? Because those two vision plans also own many of the country’s largest vision care locations. They own the labs they require doctors to use. They manufacture lenses and own the most recognizable frame brands. Dental insurance largely works the same way. This environment is hardly a free market – it’s a scheme set up to benefit insurance companies.
That’s why it’s hardly surprising that doctors and patients both come out on the losing end. Doctors are forced to cut costs or raise prices elsewhere to make up for the financial hit they take from insurers. Patients end up paying more out of pocket, have fewer options, and have a diminished ability to work with their doctor to make their own healthcare decisions.
While the federal government has largely turned a blind eye to these practices, 44 states currently have laws on the books protecting the free market and prohibiting predatory practices from vision and dental insurers. However, those laws do not apply to the one third of all vision and dental plans regulated by the federal government. It’s time for Congress to ensure patients and doctors can make the best decisions for their care without undue influence from insurers.
The Dental and Optometric Care (DOC) Access Act has been introduced in both the House and Senate by a bipartisan group of lawmakers. It would preserve the free market, protect patients, and put doctors on a more level playing field with vision and dental insurers. The bill prohibits price fixing by insurance companies, allows doctors to choose laboratories that best suit patient needs, and limits insurers from dictating network agreements longer than two years.
There aren’t many opportunities in Washington for a clear-cut, bipartisan win. This is one of them. And anyone who has experienced an eye-popping bill after a visit to the doctor or dentist understands why it’s so important—especially if they understand how much money their insurance company made along the way. It’s time to let the free market back into vision and dental care so patients can get the services and products that will do them—and not their insurance plans—the most good. Congress must pass the DOC Access Act.
