It’s Not Like People Could Keep Their Doctors Before Obamacare, People

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Obama Administration

Pundits and baggers alike are grieving over news stories about people losing their dearly beloved health insurance policies, which they had cherished through the years, and how some people may have to switch doctors even through they’d been paying out of pocket anyway, etc.

And they’re all acting as if this sort of thing just never happened before, but in fact it happened a lot.

Never mind the thousands of people who used to fall victim to “rescission” every year. That was the practice of dumping policy holders when their bills got too big — the following was written in 2009 —

In a nutshell — yesterday three big insurance company executives — WellPoint Inc., UnitedHealth Group and Assurant Inc. — told the House Subcommittee on Oversight and Investigations that their business models depended on being able to cancel the health insurance policies of customers who cost them too much money. An investigation by the Committee had found that over a five-year period, these companies had canceled the coverage of more than 20,000 people in order to avoid paying more than $300 million in medical claims.

And never mind the one-in-seven Americans who were denied coverage because of preexisting conditions. Not being able to get insurance in the first place probably doesn’t count.

And of course if you changed jobs, by choice or not, that nearly always means getting a new insurance provider. I think people kind of accepted that and didn’t complain about it.

No, let’s talk about people who got insurance through their employers before Obamacare. Especially if you worked for a small- to medium-size company with one insurance provider, there was always a possibility that your employer would change to a different provider that offered a better deal. And that new insurer might not have your health care providers in its network. I’ve personally seen this happen a few times, so it cannot have been that unusual.

In the 1990s, when HMOs were the new new thing, I actually was not able to develop a relationship with a regular health care provider. My insurance got jerked around so much that every time I needed a doctor I had to start over with a new one. Fortunately my health care issues were relatively minor.

Others were not so fortunate. I remember about 1995 I was working for a small company with maybe 40 employees, and the employer changed to a new insurance company. One long-time employee, a woman, had a husband in cancer treatment. He was covered by her insurance. You guessed it — his doctors were not in the new network. I remember her breaking down in tears when she realized this. Her husband was forced to switch doctors. I repeat, this was in the mid-1990s. I don’t believe their story was in the Wall Street Journal.

After I moved in New York early in 2000 I found a primary care physician I like very much who is in everybody’s network. So even though I’ve been covered by five different policies these past 14 or so years, I haven’t had to switch doctors. And big corporations tend to offer menus of insurance plans by more than one company, and unless your regular doctor is a complete loser he’s probably in somebody’s plan, somewhere.

But the bottom line is that under the old system, millions of Americans must have been forced to switch doctors at one time or another, and nobody boo-hooed about it. All of a sudden, now it’s the most awful thing that could ever happen to anybody.

Give me a break.

Of course, part of what’s happening now — beside the tootsie in the Wall Street Journal who lied her ass off about her old policy — is that insurance companies are making a last-chance dump of less-than-profitable policy holders. And most of it is bringing policies up to code — see, for example, Obamacare “victim” now says loss of previous health plan may be “a blessing in disguise”

I’m just calling bullshit on all the bobbleheads who are suddenly weepy about people losing their doctors. How come it never bothered you before?

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17 Comments

17 Comments

  1. Mike G  •  Nov 5, 2013 @1:19 pm

    Because when corporations do it, it’s FREEDOM (cue waving flags, bald eagles soaring).
    When government legislation brings about the exact same thing, it’s HITLER.

  2. c u n d gulag  •  Nov 5, 2013 @1:29 pm

    What @Mike G said!

    Also too, the people who matter most in the DC Village – and especially the Conservative and neo-Liberal ones who populate Morning Schmoe’s Green Room – all have internalized the meme that Democrats can’t do anything right, and, after all, that halb-schwartze Kenyan SocialiFasciCommiMusliHeathen, is a Democrat!

    And besides, it’s been a while since their tits were uproared and their knickers knotted.

  3. moonbat  •  Nov 5, 2013 @3:21 pm

    True, but prior to ACA, the shifting of people in and out of various plans happened due to market conditions (an insurer decided to stop offering certain plans or features), and occasionally due to state insurance regulators. At least in California (the state I’m familiar with), there were other insurers who offered a plethora of plans you could then buy into. Now, this is for someone on the individual market like myself, it doesn’t address employer provided plans – but the same sort of dynamic is at work. In short, this natural movement of people and plans largely happened due to market forces, and at least in California there were lots of other choices you could take when it occurred.

    Enter ObamaCare. This bit of social engineering – which I am not against on its face – has drastically narrowed the kinds of plans/features you can buy, and with it, the provider networks (or so I’m told).

    It’s one thing when this happens via market forces, it’s quite another when it’s the deliberate result of social engineering. In fact, the contrast is quite damning of this particular bit of social engineering. As someone else explained a few threads ago, ObamaCare was optimized to bring in the formerly uninsurable, at the expense of having a variety of plan features available or at-least-as-robust provider networks as before. These things were deliberately traded away in order to cover everyone.

  4. csm  •  Nov 5, 2013 @3:37 pm

    Why do all the opponents of the ACA have to lie to just to have a point of opposition? If the ACA was as bad as these people say, they wouldn’t have to lie.

    And here’s what I don’t get: given the cost of insurance and the burden on employers of having to maintain these policies, why aren’t they calling for some form of single payer?

  5. Doug  •  Nov 5, 2013 @5:17 pm

    I get Emails from a few teabagger-type conservatives who have Limbaugh for breakfast, Beck for lunch and by dinner they are full-bore insane. That’s when they typically write. *sigh* They were sure they had the government by the balls (see if that gets by the filter) with the government shutdown – and they are ready to do it again. Unbelievable. Since the turncoats foiled their perfect plan, they have been flopping about like fish in the bottom of a boat. Lots of energy expened but not much as a result.

    Despite the fiasco of the rollout (computer) and all the other inherent faults, this is going to happen and it’s going to benefit a LOT more people than it hurts. It will be a big improvement but a real solution will have to be snuck in the back door. The way I would do it a public option for a particular class, disabled single mothers. This is a group insurance companies can NEVER make money from. It won’t be hard to make it the most affordable option for moms because single payer is. Then open it up in stages to cover all single mothers, then all families, then finally even single guys.

    Just get single payer on the menu as an option. It will outclass the commercial competition and bury the medical insurance companies. Why not just do it whole hog? Because 80% of the market is on commercial and it works for them – the consumer will side with the insurance companies and it won’t pass. Do it in stages and ALWAYS make it optional – the market will gravitate to it like ugly people to WalMart.

  6. Ian  •  Nov 5, 2013 @8:15 pm

    moonbat, no. Apologies, but your understanding is incorrect. Insurance has always been highly regulated, primarily on a state level. Business decisions for when to offer policies, when to close policies, when to cancel policies, have always been a combination of market forces working within the regulatory environment of the state involved.

    Under Obamacare, the exact same thing is true.

    The only difference is that the regulatory environment has changed on a country-wide scale, and therefore a lot of the shifts that have come about due to natural market forces operating within the current regulatory environment have occurred all at the same time. Once Obamacare fully kicks in, the shifts will go back to being more localized, based on more local regulatory and market conditions.

    While Obamacare has decreased the variety of insurance products it is possible to buy, it did so by cutting from the bottom … getting rid of scams that were insurance-in-name-only, getting rid of non-scam insurance that was nevertheless not up to standard, etc. I guarantee you that as time goes by and insurers more fully understand the new environment and have time to figure out how to more closely shave every penny, the variety of products available will increase by a lot.

    As far as provider networks go, as far as I know there is absolutely nothing in the ACA that mandates the size of any provider network. What’s going on there is natural market forces at work. The market forces in play under the new regulatory environment happen to favor narrower provider networks as a way of maintaining competitive pricing. My bet would be that the way that will play out in the end is that some companies will figure out how to have wider provider networks while at the same time remaining price competitive, and they’ll use that as part of their sales pitch.

    -me

  7. anthrosciguy  •  Nov 5, 2013 @10:36 pm

    Why? For the same reason they were suddenly oh so concerned about the plight of women in Iraq and Afghanistan in 2001-2002 (and falsely claimed feminists had ignored same).

  8. c u n d gulag  •  Nov 6, 2013 @6:53 am

    ZOINKS!!!
    “Cooch” didn’t lose in VA by much!

    What’ll be entertaining over the next few days, is when the Teabaggers issues their post mortem on the VA election and come to the inevitable conclusion that Mr. Trans-vag/anti-choice/anti-oral & anal sex/pro-Missionary position only/cut taxes on the rich raise them on the workers and the poor/privatize the schools & Christian pray in them/anti-Sharia Law, lost, because he wasn’t Conservative ENOUGH!!!

    And Krispy Kreme Christie won in a landslide in NJ.
    OY!

    Cup O’ Schmoe’s show this morning will, I’m sure, feature Schmoe waxing poetic about Gov. Tony Soprano’s huge win, and how close the election in VA was.

  9. c u n d gulag  •  Nov 6, 2013 @7:32 am

    I had quite an odyssey voting yesterday.
    I went to our Town Hall, where I’ve been voting since I returned to NY State almost 5 years ago. I voted there in every election.
    So, on my way to my physical therapy session for my back, I stop off to vote. But the building is closed for Election Day, and there’s a sign that directs me towards a Firehouse across town.
    I go there after my PT, and once there, I find out that there’s no polling place there, and I’m directed to a different Firehouse – back across town, again!
    I get there, park about 1/4 of a mile away, and walk with my cane to go and vote. But once there, I’m told I have to vote at the High School, which is about 200 yards from my house.
    Everyone kept telling me that the Country Board of Elections had changed polling places – and went from 12 locations, to 8 – and that I should have gotten a yellow card with that information, and where I should vote.
    But I never got that card!!!

    So, after being directed to 3 polling places before finding the right one, and driving about 15 miles, to my eyes, it looks like voter suppression ain’t just for Southern breakfast anymore!

    I will be contacting my local BoE today, to give them a piece of my mind!
    And believe me, I know that I have precious little to spare.

  10. Sondra  •  Nov 6, 2013 @12:56 pm

    Excellent article. Back in the 90s as you mentioned, HMOs were all the rage but they were very bad indeed for the insured person. Most insurance companies actually offered choices such as PPOs, HMOs and other types of plans which were more expensive because they were like the silver and gold plans of regular private insurance.

    When people looked at their choices and that included large group plans like Blue Cross/Blue Shield, if they only looked at the prices and didn’t inquire as to the limitations they ended up with those terrible networked plans which meant they could only use the doctors that were in the network: they couldn’t keep their own doctors if they weren’t in the network. They also had to be referred to other specialists in the network: they couldn’t find the best specialist in the field they needed and just call for an appointment. Humana was the biggest player in this type of insurance and most elderly people on fixed incomes had to settle for an HMO.

    PPOs were somewhat more flexible, but still had limitations and many docs didn’t accept it because the payments were so low: you still had to shop around for a specialist.

    Most doctors have office administrators these days who deal with every insurance company and every different type of plan. If they are willing to speak with you, they can tell you what the differences are in PPOs and HMOs etc. It boils down to what is covered and how fast they get paid as to whether they accept a plan.

    If you like your doctor if would pay to ask for an appointment to get advise and information before you make a move.

  11. moonbat  •  Nov 6, 2013 @1:12 pm

    Thanks Ian, I really appreciate your insights into the insurance business.

  12. Philo Vaihinger  •  Nov 6, 2013 @1:40 pm

    Say what you will, all of this was certainly foreseen by the O team when the man went before the media, again and again and emphatically and without qualification told the nation, “If you like your plan you can keep it. If you like your doctor you can keep him.”

    Probably a prudent choice, to lie, all told.

    Though not without a price.

  13. Swami  •  Nov 6, 2013 @3:20 pm

    Probably a prudent choice, to lie, all told.

    If his name was President Svengali I might feel lied to, but holding someone to account for future events beyond their control and outside of their responsibility to interpret for others what belongs to others to interpret for themselves doesn’t constitute a lie to my mind. The law makes no demands on a person’s choice of a doctor or requiring them to initiate a change of policy.

  14. uncledad  •  Nov 6, 2013 @3:30 pm

    “If you like your plan you can keep it. If you like your doctor you can keep him.”

    hey Philo read the bill, the law grandfathered policies that were acquired before the law became effective, it is the insurance companies that have made the decision to drop the inferior policies, the law specifically allows for a waiver of the law in those circumstances. Try reading something other than Sludge, Blaze, FAUX, WND, etc dimwitted teabagger crap!

  15. Philo Vaihinger  •  Nov 8, 2013 @7:33 am

    @ Uncledad.

    First, you are mistaken, fool. Second, honest people admit it when the pols they support did what they are accused of. Nobody’s perfect.

  16. pattyp  •  Nov 8, 2013 @1:38 pm

    The irony of Obama’s “lie” is that it’s resulting in people being better off than they were before. LOL.

  17. uncledad  •  Nov 8, 2013 @2:28 pm

    Philo,

    Didn’t read the bill did you? Not suprised, your ignorance is your bliss!



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