As Congress races to finalize a major spending bill, a small but critical reform quietly vanished from the negotiating table—site-neutrality. The provision would have leveled the playing field between hospitals and independent doctors by paying them the same rate for the same services. But in Washington, common sense reforms often lose to political maneuvering and lobbyist pressure.
“Site-neutrality proposes paying hospitals the same amount that independent doctors are currently paid, which is less – much less. In fact, the estimated savings from this change would be $150 billion over a 10-year budget window…”
That’s $150 billion in taxpayer savings—gone.
Market Institute President Charles Sauer, writing in RealClearHealth, lays out how backroom deals and lobbying interests once again derailed reform that would have benefited patients, small businesses, and the federal budget.
“Politics, back rooms, a complicated bill, a tight timeline, and presidential pressure all have created the perfect storm for lobbyists and cronies in Washington, DC… Meanwhile, the average American, entrepreneur, or doctor can’t afford to loiter in the halls of Congress.”
The current system allows hospitals to charge as much as 700% more than independent doctors for the exact same services—because of outdated facility fee rules. That pricing gap isn’t about quality; it’s about government distortion and political influence.
“This disparity effectively creates a slush fund for the hospitals that they have been using to buy independent doctor’s offices – making the problem even bigger, costing taxpayers even more money, and further warping the healthcare market.”
And here’s the kicker: a bipartisan version of this reform already passed the House last Congress, with an estimated $40 billion in savings. So why backtrack? Simple: the lobbyists showed up—and the people didn’t.
“There is no other reason that members of Congress would continue funneling taxpayer money to hospitals without care. It distorts the market, and drives up the price of healthcare for their constituents.”
The good news? The fight isn’t over. Smaller, more focused bills may still advance this year—and transparency may finally win out over Gucci-clad lobbyists.
“As Sen. Grassley often says, ‘sunlight is the best disinfectant,’ and a smaller bill helps provide that sunlight.”
It’s time Congress stops rewarding cronyism and starts putting patients and taxpayers first.
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