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Insurers Push Plans Limiting Patient Choice of Doctors


Posted: Jul 18, 2010

(These are the insurance companies, folks, NOT OBAMA.)

Insurers Push Plans Limiting Patient Choice of Doctors

 
Sandy Huffaker for The New York Times

The plans, being tested in places like San Diego, New York and Chicago, are likely to appeal especially to small businesses that already provide insurance to their employees, but are concerned about the ever-spiraling cost of coverage.

But large employers, as well, are starting to show some interest, and insurers and consultants expect that, over time, businesses of all sizes will gravitate toward these plans in an effort to cut costs.

The tradeoff, they say, is that more Americans will be asked to pay higher prices for the privilege of choosing or keeping their own doctors if they are outside the new networks. That could come as a surprise to many who remember the repeated assurances from President Obama and other officials that consumers would retain a variety of health-care choices.

But companies may be able to reduce their premiums by as much as 15 percent, the insurers say, by offering the more limited plans.

“What we’re seeing is a definite uptick in interest because, quite frankly, affordability is the most pressing agenda item,” said Dr. Sam Ho, the chief medical officer for UnitedHealth’s health-care plans.

Many insurers also expect the plans to be popular with individuals and small businesses who will purchase coverage in the insurance exchanges, or marketplaces that are mandated under the new health care law and scheduled to take effect in 2014.

The remainder of the article can be found at:

http://www.nytimes.com/2010/07/18/business/18choice.html

 

;

What about those who live in rural areas and don't have access to a specialist - Backwards Typist

[ In Reply To ..]
listed with the health insurance company? I see a big problem about to rear its ugly head.

Not everyone lives in a city with a variety of specialists. Doctors refer people to specialists all the time around here. Some are listed with my insurance, some are not. Who can afford to pay a specialists the amount of $$ they charge for an operation if needed? Am I to go 50-100 miles away?

I finally called a physician in my town to get set up as my family doctor after being without one for the past 20 years. First question they asked, "Who's your insurance company?" Then I had to go to the office so they could copy my card so they could find out if my doc would be listed with my insurance. Otherwise they wouldn't take me on as a new patient. This was only 4 weeks ago. What will happen in 2 years? Will I be without insurance/doctor again?

This is the insurance companies talking. (sm) - Nikki

[ In Reply To ..]

It's not Obama here.  It's the insurance companies.  Just so we're clear, since everyone likes to blame Obama for everything.  The insurance companies are just trying to put a squeeze on their customers -- again.

I realize it's the insurance companies but - Backwards Typist

[ In Reply To ..]
who's getting the benefit from health care? Not the people. The insurance companies are and why do I think that? Because they had most of the say what goes in, or doesn't go in, this law. They compromised on some stuff, but insurance companies will still be the lord and master of health care.
Exactly! That's why I was in favor of single-payor. (nm) - Nikki
[ In Reply To ..]
:-)
please explain to me how the single payer works. - nm
[ In Reply To ..]
.
Roughly, it works like Medicare or Medicaid. (sm) - Nikki
[ In Reply To ..]
There would be no need for insurance companies and their cruelty and greed.
Cons to single-payer - sm
[ In Reply To ..]
Produce long waits and reduced quality. Over 800,000 people are waiting for hospital care in the U.K. In Canada the wait between a general practitioner's referral and consultation with a specialist has been "over 17 weeks." Other problems include "strict drug formularies, limited treatment options and discrimination by age in the provision of care." Price controls "result in reduced drug, technology, and medical device research."

Result in funding crises. Since the individual doesn't pay the direct costs of treatment, demand expands. The government then needs to control costs and rations products and services. That, in turn, leads to the retention of outdated facilities and medical equipmentófor example in Canada, where an estimated 60 percent of radiological equipment is outdated.

Create new inequalities. Tgere is often favoritism for the politically connected, limitations on surgeries for the elderly and care for premature babies and restrictions on access to specialists.

Foster labor strikes and personnel shortages. In 2004 a Canadian strike in British Columbia resulted in the cancellation of 5,300 surgeries and numerous MRIs and CAT scans. In Britain, recruiting and retaining doctors is a problem.

Lead to politicization and lost liberty. The elite dictate health care needs.

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