Price capping in any form is a restriction on liberty. It is why we have cost-shifting across the health system. Keep federal government out of my exam rooms and business office, and the free market will work. By imposing a cap, providers will be inclined to price up to that sooner, knowing that long term their ability to generate income will be capped. As with every government intrusion, perverse incentives result and market behavior changes.
This bill, it has been revealed, was written under the false pretences that those at the table were representing independent practices. It was written ONLY with the needs of those special interests in mind. That is why is was scored so high, JCT knows the special interests want to jump all over DPC and HSA purchasing may explode. Interestingly, there are corporate models that do not and will not bill ancillaries at a discounted, transparent price; those services will still go through insurance. Are these even DPC practices? It was brought to Ways and Means attention that independent practices were not represented and practice differently than what was presented, but not before it was too late. The bill fits nicely with the corporate models and soon-to-come Aetna/CVS, Humana/Walmart, Amazon deals (aka HR 5138 -- look who was involved with The Moran Analysis of this bill back in March 2018 which is now also bundled into HR 6199 all of whom will probably start DPC models and build it into their insurance products). Money talks and so do campaign contributions and paying to be on Steering Committees. There are many, many, many flaws with this bill, the payment cap being one of them. No where, and at no time has the Federal Gov't legislated payment caps on the American Public's own, personal health care dollars. I can go buy a $500.00 pair of Chanel prescriptios eyeglasses but I can't spend more than $150.00 on a DPC doc (and that is a total, what if I want to see TWO direct care docs, a FP and IM)? This is a very worrisome precident to set for other HSA elligible expenses. AND this bill does designate DPC as a form of health coverage under 223 statute as the interviewee states. This has been the assessment of other policy experts around the country. The interviewee is trying to save face and spin it so his special interests get what they want.