Crocodile Tears

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Health Care

An article in the Financial Times warns us of a shortcoming in policies purchased through the insurance exchanges:

Amid a drive by insurers to limit costs, the majority of insurance plans being sold on the new healthcare exchanges in New York, Texas, and California, for example, will not offer patients’ access to Memorial Sloan Kettering in Manhattan or MD Anderson Cancer Center in Houston, two top cancer centres, or Cedars-Sinai in Los Angeles, one of the top research and teaching hospitals in the country. …

…It could become another source of political controversy for the Obama administration next year, when the plans take effect. Frustrated consumers could then begin to realise what is not always evident when buying a product as complicated as healthcare insurance: that their new plans do not cover many facilities or doctors “in network”. In other words, the facilities and doctors are not among the list of approved providers in a certain plan.

(I had to check to be sure the article was written recently, and not in the 1990s, when “networked” policies were the new new thing. Yep, the date on it is December 8, 2013.)

OK, so the concern here is that people buying insurance through the exchanges, the majority of whom have no isurance whatsoever now, will not have access to some big-name facilities, which they don’t have access to now, either. Also, people might have to get used to dealing with “networked” health care, which apparently will be a new experience for lots of people even though the majority of us have been limited to some network or another for at least the past 20 years. Is that the issue?

Elsewhere, righties are snarking because the cheapest exchange policies come with high deductibles. These are the same people who have touted high-deductible policies as the answer to affordable insurance for years.

Many of these crocodile tears are being shed by people who’ve been on employee-paid group plans all their lives and have no idea how much insurance really costs. Ryan Cooper writes that maybe members of Congress will learn something –

Right now, one of the primary ways Congressional Republicans are attacking Obamacare is to cite the sob stories of Congressional staffers — and lawmakers themselves — who are having a bad experience with the law. Thanks to a bit of Republican legislative trolling that forced Members and their staffs onto the exchanges to make a political point, some are discovering that premiums are higher than they would have expected, having previously enjoyed the protection of government benefits that essentially shielded them from reality.

But if anything, the fact that Members of Congress are now having an unpleasant brush with the American health care system is a good thing. These Members are experiencing the same American health care system that the uninsured and people with preexisting conditions have been experiencing for many years. They are being forced to face the fact that American health care costs a lot, which, of course, is one of the reasons reform is so hard.

I say they won’t learn a damn thing. They’ll just assume everything was fine before the ACA passed.

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7 Comments

7 Comments

  1. PurpleGirl  •  Dec 9, 2013 @5:23 pm

    I doubt that the congresscritters will ever understand what regular people go through. Maybe some staffers will but not the congresscritters.

    I currently don’t have insurance and I don’t have a job. I’m getting my health care at a clinic at a NYC-run hospital. They charge me on a sliding scale per visit and per drug. I’m not quite sure where I stand in relation to ACA, though.

    There are some down sides: the doctors are there as part of their training at Mt. Sinai Hospital and may change between your visits; and you may have 3 months between appointments. But it beats not having any care at all. Yes, NYC has high taxes which I paid for many years, but their hospital system at least works for most people.

  2. c u n d gulag  •  Dec 9, 2013 @5:37 pm

    “They’ll just assume everything was fine before the ACA passed.”
    Well, they assume everything was better before the Civil War.
    And they assume everything was better in The Gilded Age.
    And they assume everything was better before women got the right to vote.
    And they assume everything was better before the military was integrated.
    And they assume everything was better before the Civil Rights Acts.
    Etc…

  3. Bill Bush  •  Dec 9, 2013 @7:39 pm

    I’ve got proof they are not as dumb as they seem: no congresscritter has ever offered to let the folks back home pay them what those folks think they’re worth, benefits included. However, they have dodged that one by accepting what the lobbyists think they are worth.

  4. Mike G  •  Dec 9, 2013 @7:48 pm

    Every problem evident in the US medical system is now the fault of Obamacare.
    A wingnut co-worker has blamed our increase in out-of-pocket premiums at work on Obamacare; never mind that these have been rising faster than inflation since the early 90s. I guess Obama was really powerful as a community organizer in Chicago and then an Illinois state senator to make healthcare costs go up across the nation.

  5. erinyes  •  Dec 9, 2013 @8:07 pm

    As if that’s not bad enough, I learned today that the NFL is a nonprofit organization, their stadiums are built with tax payer funding, and they negotiate the property taxes on their facilities. Are you ready for some football ? Oh, the head honcho makes 30 million per year.

  6. Doug  •  Dec 9, 2013 @10:03 pm

    There are legitimate complaints about deductibles and coverage within networks. I am in company with President Obama – any suggestions how to make it work better are welcome. I will gladly read, evaluate, investigate and comment on any objective suggestion. (Snark does not qualify.) Any improvement I will actively support. Finding flaws without a proposal to address the issue is NOT a proposal for an improvement. A legitimate complaint by itself ignores the circumstances that AHC does address. A complaint without a constructive proposal or a complaint that does not request that the defect be addressed and the fix incorporated into Obamacare is an implied request that we return to the old system. That’s not reform – it’s passive obstruction.

  7. dr. luba  •  Dec 14, 2013 @1:53 pm

    I got the same line from a neighbor several months back–that, horrors, I would be limited to what hospitals and doctors would be covered under Obamacare. He is an old guy, on Medicare.

    I told him I have that already. And have had since 1990. Short of straight up Blue Cross, I don’t know of any non-government insurance policies that don’t have networks.



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