Even amid conflict in Iran and rising gas prices, healthcare affordability remains a top voter concern. KFF reports that 64% of adults are worried about affording healthcare costs, including insurance, office visits, and prescriptions. Republicans looking for a cost-saving, pro-patient item for a “reconciliation 3.0” should start with one of the most obvious distortions in American medicine: Hospitals get paid more than independent physicians for the same care.That payment mismatch is not a minor accounting problem. It is a business model. Federal rules allow a hospital outpatient department to receive higher reimbursement than an independent physician office for identical services, even when quality, complexity, and patient risk are the same. Once the payment is higher, hospitals have every incentive to buy independent practices, rebrand them as hospital outpatient departments, and send patients a larger invoice.
WHITE HOUSE EYEING SECURITY AND SAVE ACT COMPONENTS IN THIRD RECONCILIATION BILL
The predictable result has been consolidation, higher prices, and fewer choices. Nearly 4 out of 5 physicians now work for hospitals, health systems, or other corporate entities, and roughly 6 in 10 practices are owned by hospitals or corporate owners. Patients experience this as shrinking access, higher out-of-pocket costs, and the quiet disappearance of the independent physician.
