Knock Knock Eye: Why Insurance Companies Are Simply Ignoring No Surprises Act Rulings

My most-viewed post ever on Instagram is a video of me in my Jawa costume scaring my kids and their friends around a fire pit on Halloween. Fifteen million views. It taught me something about spheres of influence and why I still won’t put my kids’ faces on the internet. I also get into the recent Learjet crash, the misogyny thrown at the female co-pilot, and the striking parallel between how pilots and physicians train the next generation.

Then the main course, a new New York Times story on the No Surprises Act arbitration system. Doctors are winning 70-80% of arbitrations. Insurance companies are just refusing to pay the rulings. There’s no enforcement mechanism. I didn’t invent this problem, but it’s the one I want someone to actually fix post-midterms (I recorded this on election day).

Takeaways:

• The dark months are particularly hard on interns past their July grace period, so experienced clinicians should actively support trainees’ mental health through the winter.
• Content creation has distinct “spheres of influence,” and lifestyle or family content reaches dramatically wider audiences than healthcare content
• The misogynistic social media response to the Learjet crash’s female co-pilot mirrors the dynamic physicians see with medical misinformation, with people confidently attacking trainees who are learning under experienced mentors.
• A recent New York Times investigation found insurance companies are simply refusing to pay arbitration rulings under the No Surprises Act, despite losing 70-80% of those disputes.
• There is no real enforcement mechanism forcing insurers to comply with No Surprises Act arbitration outcomes, which is the single biggest fix Will wants from post-midterms healthcare policy.

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