We have already mentioned the broken promise that no one
would have to change their health plan if they liked it.
There was another con in the selling of Obamacare; you would
not have to change your doctor or go to another hospital.
In order to make their plans offered under the Exchanges
economically profitable the Insurance Companies offering plans have resorted to
reducing the number of participating physicians in their panels to consist of
those that would accept lower reimbursement rates.
In many cases where Physicians were participating as panel members
of the company’s established programs they found themselves without any explanation
excluded from the “Exchange” plan.
There seems to be a tendency to exclude large multispecialty
groups. Also in many cases specialist who are recognized as tops in their field
and participating in the carrier’s other plans are not available to those
insured in the new plans.
Likewise the carriers were making separate deals with the
hospitals again offering reimbursement that often approached Medicaid levels. We
know that one of the causes of urban hospitals bankruptcy and closures was the
large load of patients under that program contributed to the negative cash flow
which made it impossible to stay in business.
The hospitals that accepted the offered contracts are
relying on a quick turnover of patients and literally short stays and “hot beds”.**
It is quite possible that even though there is a local
hospital a patient covered under one of
these policies will have to a great distance if hospitalization is needed, and
it may be to one in which your doctor does not have the right to treat patients
In either Vermont or
New Hampshire where only one carrier is
offering insurance under the Exchange; a doctor who is Chief of Staff at a
hospital will not be able to great her patients at that hospital because the
plan did not make a contract with it.
One of the results of these practices is that certain
hospitals that are excluded are recognized as tops in their fields are closed
to those insured under the new policies. That certainly would suggest that
despite promises one’s health care is being compromised under the ACA.
In New York most of the carriers will not pay for patients
to go to Memorial (Sloan Kettering) in New York. That means if you have a
cancer the latest and best treatment will not be available to you unless you
are going to go out of covered services.
In Connecticut United Health Care has excluded the Yale Hospital
a teaching institution and also the large medical group associated with the
school and hospital. There are thousands of patients who will have to seek new
doctors.
Stories like these are common in every state. So much for
the promise that you can keep your doctor.
The carriers have admitted that a small panel of doctors and
hospitals makes it easier to control expenses.
(More to come)
** During WWII with increase in the large number of factory
workers and three shifts because of
room/bed shortages it was customary for “hotels” and Boarding Houses and homes
to rent a bed or room to three different individuals for the eight hour period.
If the linen was changed or not is open to question.
In Plainfield Truel Court across from the Fire Headquarters
had that reputation.
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