OC: ObamaCare is Great… As Long as You Don’t Need to Go to a Hospital

Daniel Greenfield  


The New York Times belatedly admits what ObamaCare really is, it’s an incentive to create “commercial” versions of Medicaid plans financed by the forcibly enrollment of the country’s healthier population into those plans.

It’s the worst combination of private and public health insurance possible with the government pushing to make the plans as broad as possible in coverage while insurers compensate by making its networks as shallow as possible. So you can get your birth control and your obesity counseling anywhere. Those are the things the social planners really care about bringing to minority communities. Just don’t count on having access to a specialist to treat more serious medical problems.

Federal officials often say that health insurance will cost consumers less than expected under President Obama’s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers.

That’s how health insurance works. That’s why it’s profitable. If the government sets price controls and coverage areas, the insurers will compensate through WalMart tactics. You can get discounts, but at the cost of product quality.

Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.

Or you know, the NHS, which Obama used as a model.

Consumers should be prepared for “much tighter, narrower networks” of doctors and hospitals, said Adam M. Linker, a health policy analyst at the North Carolina Justice Center, a statewide advocacy group.

If you like your doctor, better hope that he’s a Ghanian resident at your local city hospital. Or you won’t get to keep him.
Insurers say that with a smaller array of doctors and hospitals, they can offer lower-cost policies and have more control over the quality of health care providers. They also say that having insurance with a limited network of providers is better than having no coverage at all.

The former is true,  but it isn’t quality of care, but quality of profits that they are interested in. The latter may be true, but we could have had that without a massive government mess and compulsory national insurance. Low cost plans did exist.

In a new study, the Health Research Institute of PricewaterhouseCoopers, the consulting company, says that “insurers passed over major medical centers” when selecting providers in California, Illinois, Indiana, Kentucky and Tennessee, among other states.
“Doing so enables health plans to offer lower premiums,” the study said. “But the use of narrow networks may also lead to higher out-of-pocket expenses, especially if a patient has a complex medical problem that’s being treated at a hospital that has been excluded from their health plan.”

That’s not a bug. It’s a feature.

Daniel R. Hawkins Jr., a senior vice president of the National Association of Community Health Centers, which represents 9,000 clinics around the country, said: “We serve the very population that will gain coverage — low-income, working class uninsured people. But insurers have shown little interest in including us in their provider networks.”
Dr. Bruce Siegel, the president of America’s Essential Hospitals, formerly known as the National Association of Public Hospitals and Health Systems, said insurers were telling his members: “We don’t want you in our network. We are worried about having your patients, who are sick and have complicated conditions.”

Why would they? Insurers are hunting around for the captive audience of young, stupid and healthy twenty-somethings that Obama promised to turn over to them.
The other patients are going to end up in the network anyway. But they’re going to end up with doctors whose main priority is controlling costs. Again, it’s the WalMartization of medicine and ObamaCare is accelerating that trend. Profitable practices will either go private or they will focus on treating patients as little as possible while complying with every regulation.
That’s how national health care works everywhere.

In New Hampshire, Anthem Blue Cross and Blue Shield, a unit of WellPoint, one of the nation’s largest insurers, has touched off a furor by excluding 10 of the state’s 26 hospitals from the health plans that it will sell through the insurance exchange.
Christopher R. Dugan, a spokesman for Anthem, said that premiums for this “select provider network” were about 25 percent lower than they would have been for a product using a broad network of doctors and hospitals.
Anthem is the only commercial carrier offering health plans in the New Hampshire exchange.
Peter L. Gosline, the chief executive of Monadnock Community Hospital in Peterborough, N.H., said his hospital had been excluded from the network without any discussions or negotiations.
“Many consumers will have to drive 30 minutes to an hour to reach other doctors and hospitals,” Mr. Gosline said. “It’s very inconvenient for patients, and at times it’s a hardship.”

Welcome to ObamaCare.