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View Diary: ACA's narrow networks allow insurance companies to gouge public, doctors (97 comments)

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  •  The problem we have is that people here (1+ / 0-)
    Recommended by:
    OrganicChemist

    are used to the "average" person, with employer provided insurance, is used to getting to see the doctors he/she wants, and going to the hospital he/she wants. For example, I'm in New Orleans, and many people here diagnosed with some serious form of cancer choose to go to M.D. Anderson in Houston.  You hear about that regularly.  

    It may well be that, five years from now, people in the exchanges (and I expect that to be more and more people as time goes on), or people who don't make enough to pay for that "extra tier" coverage, are not going to have access to those resources, and will find fewer choices and longer waits for care, and will find doctors spending less time with them, as insurers limit their options to doctors who will accept lower reimbursements, and therefore must crowd in more patients in a day so as to cover expenses and still make money..  The "best" hospitals, doctors, and care facilities, the notion of calling and getting an appointment fairly quickly, the notion of a doctor spending 30 or 45 minutes with you, will be largely for those who pay for that "extra tier" coverage.

    And I'm not sure how well that will be received  here, frankly.

    •  Hahahahahaha (2+ / 0-)
      Recommended by:
      Roadbed Guy, Tonedevil
      the notion of a doctor spending 30 or 45 minutes with you
      I've got pretty darn good employer provided insurance. I can't recall if I've ever - EVER - had 30 - 45 mins with a doc. They've been crowding in more patients a day for years.

      “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

      by Catte Nappe on Sun Nov 24, 2013 at 04:41:47 PM PST

      [ Parent ]

      •  My doctor does. Both (1+ / 0-)
        Recommended by:
        Catte Nappe

        my internist and my Ob-Gyn -- generally, it's half an hour or more at my annual checkup.  That counts the exam, and questions (my internist discusses lifestyle, diet, risks, etc.).  

        I actually checked at may last annual checkup with the internist because someone asked me.  that one was 40 minutes.  

        •  I'm lucky to have the same experience... (2+ / 0-)
          Recommended by:
          coffeetalk, Tonedevil

          My primary care physician never rushes my visits. She will take time every visit to review all my health history and talk about what is happening with my family, etc. I once commented on the time she seems to be able to take and she commented that as long as the Medicare and Medicaid load on the practice is low, she can take as much time as necessary. If she and her partner were to accept Medicare patients, then they would need to resort to shotgun doctoring to stay in business. Right now, they do no Medicaid and only accept Medicare patients who have "graduated" from being regular billing patients.

      •  But I frankly think that the limits on (0+ / 0-)

        hospitals and such facilities will be the biggest problem.  How upset will people be who are diagnosed with serious cancer, and then find out that M.D. Anderson is "not in network"?  

        I have a friend just diagnosed here in New Orleans with serious lung cancer (very sad -- never a smoker, in her late 50's).  She immediately chose to go to M.D. Anderson rather than stay at the hospital in New Orleans.  I suspect those kinds of options will be less and less available, unless you can avoid extra for the higher tier insurance.  

        •  What ought to be our basic level of care? (0+ / 0-)

          Should we insure that everyone who gets cancer goes to the most expensive prestigious hospitals to be treated? I don't see how that is possible.

          •  That's probably realistic. But my point is (0+ / 0-)

            that people with "average" employer provided heath insurance are used to that -- like the friend I mentioned. She and her husband have good jobs, but are certainly not what I would consider "rich."

            I think a lot of people are going to be unhappy when they discover that their former expectations no longer realistic.

            I think you are right -- it probably is necessary.  But it' will come as an unpleasant surprise to people who were promised that the ACA could cover a lot of additional people without any downside to those who had insurance that they liked.  The Administration did not manage expectations well at all, and I think they are feeling the results of that, and may feel them over the next year as well.  

            •  I think you are right (0+ / 0-)

              I've heard acquaintances in California lamenting that the most expensive hospitals are no longer in their network. They maintain that they ought to be able to see any doctor, go to any hospital, and their insurance should pay. They are furious that they have to pay more for insurance, and it doesn't cover any hospital they want to go to.

      •  My son's doctor always spends that much time (1+ / 0-)
        Recommended by:
        Catte Nappe

        during every visit.  Hence one of the reasons I have chosen him to be my son's doctor.

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