The Obama administration made it a priority to keep down the cost of insurance on the exchanges, the online marketplaces that are central to the Affordable Care Act. But one way that insurers have been able to offer lower rates is by creating networks that are far smaller than what most Americans are accustomed to.
In our discussion of Obamacare implementation the earlier this week, Megan McArdle warned of this. She called it “doc shock,” as people find that the most reputable health care providers are not in their plans. She said that the out-of-network co-payments are often 100 percent, meaning that the insurance company pays zero and the consumer has to pay everything. This will probably not go over well.
I’m really not seeing that the ACA is doing anything to keep costs down either. The plan seems to be maintain prices at their current highs by forcing everyone to pay somewhere between $200 and $1500 per month for “insurance”, and also to force most people to pay out of pocket when they actually need care by increasing the deductibles. They keep using that word “affordable”, but I don’t think it means what they seem to think it means.
You know, it’s always the people who fight to keep government from economic intervention who are accused of politicizing health care, science, etc.
But now this slow motion train wreck gives us all the opportunity to witness in stark relief what it really means to politicize something — in this case one-seventh of the economy. Putting off the exchange browsing feature because it doesn’t show subsidized price. Encouraging such low prices that new plans are lamer than a free market would supply. Delaying 2015 enrollment until after 2014’s elections. It’s delicious.
Does anyone understand that this legislation was the product of the **un** elected put into effect by the elected (who did not and could not comprehend the comprehensive) through deviations from the processes which were the limits of their comprehension?
Spoken like someone who has had little experience with health insurance. The networks offered through many of the employers I had were so small, finding a doctor actually accepting new patients was difficult.
The difference, of course, is that you could have gotten a better job. Or at least a job with better health benefits. With guaranteed issue now being the law of the land, and premium increases being subject to some state insurance commission’s whim, shrinking provider networks are likely to become a fact of life for almost everyone.
These were premium jobs but like most things it is difficult to evaluate value so everyone chooses cost, but it illustrates this is nothing new and in fact this may well be reduced under new arrangements where micromarkets will disappear and only mass markets will be left.
Hm, one would think the artificial relationship between employment and healthcare should be severed, in that case. Doesn’t that seem to be the biggest source of market failures in US healthcare?
Insurance companies can no longer deny coverage to those persons with existing illnesses.
But these persons are still a terrible drain on profits.
Therefore, the insurers want to discourage such people from joining their plans by excluding the top specialists and academic hospitals.
The theory is that any insured who even cares about who is in the network is a bad customer. This insured either has an illness already or feels they may get one soon.
Let me move on to another question. Why would a specialist or hospital accept being excluded from a narrow network? Would they not try to lower their fees so that they could be included?
Maybe specialists can make enough money just from cash patients. Maybe academic hospitals can make enough money from Medicare and from more generous insurance plans.
I wonder if the nation is lumbering painfully toward a national fee schedule. I do not think that would be a bad thing.