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Author Topic: The Cost May NOT be the NASTIEST Surprise with ObamaCare Back to Topics

Champion Author

Joined:May 2004
Message Posted: Nov 1, 2013 8:54:12 PM

"Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare…

Regulations driven by the Obama White House have indeed made insurance more affordable – if, like Health and Human Services Secretary Kathleen Sebelius, you’re looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered…

“Many companies have selectively entered the exchanges because they are concerned that (the exchanges) will be dominated by risky, high-using populations who wanted insurance (before Obamacare) and couldn’t afford it,” said Wilsensky, who is also on the board of directors of UnitedHealth. “They are pressed to narrow their networks to stay within the premiums.”

Consumers, too, will struggle with the new system. Many exchanges don’t even list the insurance companies on their web sites. Some that do, like California, don’t provide names of doctors or hospitals.

Turns out you can’t expand coverage, cap patient costs, and expect providers to work for less, just like you can’t create the conditions for a major adverse selection problem and expect insurers to flood into the new market. “Some hospitals and doctors don’t even know if they are in the network,” says one expert, a point also made in the WSJ story I flagged this morning about consumers often having no idea who’ the providers are in each plan offered on the state exchanges. That’s not a newly discovered “glitch,” either; the NYT noticed two weeks ago that asking people to comparison-shop among dozens of different plans without telling them which doctors accept which ones leaves them in the dark about a key consideration of their coverage. Essentially, if you’re trying to decide between three or four different plans, the only way to tell if a provider accepts any or all of them is either to call various doctors you’d like to see and run through it with them (imagine being the receptionist fielding hundreds or thousands of those calls) or go to the individual corporate website, find the plan you’re interested in, and then hunt around on the site to see if a particular doctor carries it. This is, of course, the opposite of what the online exchanges were supposed to do; the whole point was to allow for simple, one-stop shopping where you can compare the particulars of different plans side by side.

From what I can tell, the feds’ solution to the provider problem thus far has been simply to not talk about it. Which makes sense from a PR standpoint: Given all the other flaming wreckage they have to deal with, why force the issue of coverage networks being smaller than everyone anticipated until it’s absolutely necessary, i.e. on January 1, when coverage takes effect? It’s irresponsible, though, insofar as they’re pushing consumers to focus on the cost and comprehensiveness of the coverage they’re buying on the exchanges and that’s going to lead them to overlook the provider-network component, which will end up being a nasty surprise later in some cases. You’ve got middle-class people deciding to buy Plan A instead of Plan B because the former’s a bit more affordable and meanwhile, unbeknownst to them, the fine print says that Plan A includes far fewer providers than Plan B does. If you think the media’s been tough on O-Care lately, wait until January when “rate shock” segues into “provider shock.”

Link to source

It's like saying, "Hey, I got a good deal on a car today, but I don't know what kind or where I can pick it up, and I'm not sure what options it has...
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Champion Author Dayton

Joined:Feb 2006
Message Posted: Nov 2, 2013 11:37:27 PM

Great topic, Tim. And the overwhelming rancor from the liberals here shows what the score really is. (13-0 before I posted this)
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Champion Author Twin Cities

Joined:Jun 2009
Message Posted: Nov 2, 2013 8:19:52 PM

Interesting article. Like most Americans I have my health insurance through my job, yes I work for a living, and hopefully I will be able to avoid ObamaCare for as long as possible.

The plan my employer offers allows me to go to pretty much any provider in the Minneapolis area. Other plans out there, usually ones people buy on their own, limit you to going to only certain hospitals or selected doctors if you do not want to pay "out of network fees".

All I ask for is that my health insurance be left alone. I like it the way it is, it works good for me and I want Obama and his partners in crime to leave it alone.
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Champion Author Cincinnati

Joined:May 2008
Message Posted: Nov 2, 2013 6:56:47 PM

"Now that the predictions are coming true what do we hear? This is disaster is all the resist Republicans fault."

Undoubtedly Obama, Reid, and the rest will try to blame Obamacare's failure on the fact that no republicans voted for it and then they sabotaged it. I know that doesn't sound logical, but that's what will happen. As republicans controlled none of the implementation plans, and indeed couldn't stop it even if they tried (Cruz made the best effort and he failed), they will still get blamed. Soon it will be time for republicans to start running commercials to cement the democrat's ownership of this entire debacle before the democrats start trying to spin it otherwise.

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Champion Author St. Louis

Joined:May 2011
Message Posted: Nov 2, 2013 6:40:09 PM

The sad part is that most of these problems were predicted. The shift of employees to part time was predicted. The fact that the cost would be much higher than stated was predicted. The idea that employers would drop healthcare and move people to the exchanges and just pay the tax (penalty) was predicted. It was fact that healthcare premiums would go up in price not down was predicted because you can’t force a provider to spend more and not charge more. What happened to the people who were smart enough to see what would be the real effect of Obamacare? They were accused of being mean, greedy, racists who wanted to watch the poor die off. They were called obstructionists who only wanted to appose the president because it was Obama.

Now that the predictions are coming true what do we hear? This is disaster is all the resist Republicans fault. How bad will have to get before people stop living in la-la land and understand the reality of economics.
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Champion Author Cincinnati

Joined:May 2008
Message Posted: Nov 2, 2013 5:52:31 PM

Yes greentre, a whole lot of people are getting what is probably their first real world civics lesson as they open their mail and then try to replace their lost insurance. Today's civics lesson 101 is that socialism is a great political system right up to the moment at which you find yourself participating in socialism on the sending side of the wealth redistribution curve.

I'm just happy that the vast majority of those people who are receiving this lesson voted for Obama and democrats. Maybe some of them will rethink whether it's worth it or not to feel good about themselves for how they voted now that they realize the package containing that nice feeling came with a hidden clenched fist inside that just smacked them in the chops.

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Champion Author Pensacola

Joined:Oct 2011
Message Posted: Nov 2, 2013 5:15:14 PM

"California residents are rebelling a bit against Obamacare, with thousands shocked by the sticker price and rethinking their support, saying that what seemed wonderful in principle is not translating so well into reality."

"As Pam Kehaly, the president of Anthem Blue Cross in California, reported, she received a letter from one woman who saw her insurance rates rise by 50 percent due to Obamacare."

“She said, ‘I was all for Obamacare until I found out I was paying for it,’ ” Ms. Kehaly said, in the Los Angeles Times."

Who did you think was going to pay for it?

"Jennifer Harris, Fullerton resident, said she was shocked to receive a letter from her Health Net Inc. insurer that her plan — which costs $98 a month — was being dropped. The cheapest plan she said in the Los Angeles Times that she found is $238 a month."

“It doesn’t seem right to make the middle class pay so much more in order to give health insurance to everybody else,” she said, in the report. “This increase is simply not affordable.”

Here's the wealth redistribution you asked for. Yes it is affordable, just ask the powers-that-be.

[Edited by: greentre at 11/2/2013 5:18:11 PM EST]
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Champion Author Los Angeles

Joined:Aug 2004
Message Posted: Nov 2, 2013 11:12:04 AM

I think this is showing us that a free market solution would have been better. I liked the way Obama Spokesliar Jay Carney basically lied through his teeth for Obama. He said something like "Of course you can keep your health care plan, if it still exists."

Of course, the reason the plans don't exist anymore is BECAUSE of ObamaCare. Here, now. Did you know that now AARP must offer pregnancy and contraception coverage. Think about that.. for people over 55? And why would you or anyone think that with having to offer care for such conditions, that it can't possibly go up in price? And what about preexisting conditions? How is it possible to take "all comers", yet pay a low price? That cost must be driven up for everyone. And the young people who are supposed to be paying for all of this aren't signing up in droves. They've made the economic decision to pay the $95 fine on their taxes, and just pay for their rare doctor visits out of pocket.
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Champion Author Montgomery

Joined:Aug 2008
Message Posted: Nov 2, 2013 9:56:13 AM

TT, I brought this up a long time ago. The "allowables" that the budget companies will pay will be lower than most doctors will be able to accept to make a living. What is going to happen is people are going to end up owing money to a doctor as an out of pocket expense along with their co-pay to make up the difference. This is going to cause more people to have credit issues because they will not pay it.

I work with credit every day at work and I can tell you that it is amazing the number of people that have "medical" listed on their credit reports as being in collection. The sad part about it...most of them are less than $50...people do not pay their co-pay is what it is. Basically the people claiming that medical is the #1 thing on people's credit when they file bankruptcy is a bit of a myth because it is not from not being able to afford medical is from not paying little bills like co-pays! I see it daily folks...
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Champion Author Tampa

Joined:May 2004
Message Posted: Nov 2, 2013 7:19:14 AM

teacher_tim said: >It's like saying, "Hey, I got a good deal on a car today,...<

And has ANYONE even gotten that good deal? If it was such a great deal, I'm sure there would have been a lot more than 6 people who signed up on the first day, regardless of the disastrous roll-out. So far, we're really heard instances like the famous Chad Henderson who bragged that he & his father enrolled (when they didn't) and was excited about the great deal that he got, which was about 4 times what he would have paid for equivalent coverage before ObozoCare would drive the plan from existence.
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Champion Author Philadelphia

Joined:Jun 2004
Message Posted: Nov 2, 2013 4:42:22 AM

How about Freedom of choice? (violations of citizens' 13th amendment civil rights?)
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Champion Author Michigan

Joined:May 2007
Message Posted: Nov 2, 2013 12:33:11 AM

The nastiest surprise is that nobody in their right mind will pay these prices for a plan that is pretty much 100% out of pocket for the first $5000. The average American household doesn't consume this much healthcare!

The taxing effect on our economy will be staggering while gray faced Pelosi tells us in her Bugs Bunny voice how much more "benefits" we have.
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Champion Author Cincinnati

Joined:May 2008
Message Posted: Nov 1, 2013 10:52:04 PM

tt: "From what I can tell, the feds’ solution to the provider problem thus far has been simply to not talk about it."

On top of that it's my understanding that most of the lower level plans are HMO only and they don't pay anyone who is out of network. I wonder what happens if you are out of state and have a medical emergency? Under the old HMO rules this sort of thing was covered if you had an emergency, but because of all the doctors intending not to participate at all because they won't accept such low payments, I'm not sure that's still the case. If not, and you leave town and are in a car wreck or something, by the time you regained consciousness a few days later you could be hundreds of thousands of dollars in debt.

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Champion Author Pensacola

Joined:Oct 2011
Message Posted: Nov 1, 2013 10:32:09 PM

My wife works in provider enrollment and she says the number of doctors quitting is on an uphill curve. Couldn't be from Obamacare, could it?

Btw, provider enrollment includes credentialing, endorsement, and licensure verification of doctors to ensure that they are in good standing in the medical community. For those that may not have heard of this field.
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