Obamacare enrollees having trouble finding specialists

[Sbane]

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http://www.kaiserhealthnews.org/Stories/2014/July/17/narrow-networks-specialists-community-health-centers-insurance.aspx

[jaichind]

This is a feature not a bug.  It is the users of Obamacare did not get the memo on that one.

[Indy Texas]

Again, there is no such thing as a free lunch.

These people went from not being able to see a specialist period due to lack of insurance to having a handful of specialists to choose from. I fail to see how that's not an improvement over their prior situation.

[Small Business Owner of Any Repute]

If you buy the absolute cheapest Bronze plan, you're going to struggle to get the same access and quality of care as someone who pays more for a mid-range Silver plan. That really shouldn't be a huge surprise to anyone.

[Sbane]

Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.

[King]

The Bronze plan is supposed to be for people who don't need to see specialists on the regular. The so called "young invinceables" crowd.

Libertarians have nothing to talk about either if they care about this, as the Pauls'stated healthcare plan is all about "catastrophic coverage" as a common insurance practice for the young, which is the narrowest specialist network you can ask for: none.

[King]

Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.

I will concede the premiums are high for some right now, but 2014 is really the peak of pricing for these plans. They were built on conservative estimates for enrollment that were shattered and will only be aided by more Medicaid state expansions over time.

[memphis]

If you buy the absolute cheapest Bronze plan, you're going to struggle to get the same access and quality of care as someone who pays more for a mid-range Silver plan. That really shouldn't be a huge surprise to anyone.

I bought the absolute cheapest bronze plan and have had no insurance problems. All my docs, and a few new ones, have taken my BCBS exchange policy with zero problems. I'm sure somebody, somewhere has had an issue with a plan's network, but that's true of non-exchange plans as well and has nothing to do with the ACA. This is typical misleading, clickbait nonsense.

[memphis]

Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.

Insurance is not supposed to be a good deal. It's not an invrstment. It's insurance. It's there to cover your Inks just in case something terrible happens.

[jaichind]

If you buy the absolute cheapest Bronze plan, you're going to struggle to get the same access and quality of care as someone who pays more for a mid-range Silver plan. That really shouldn't be a huge surprise to anyone.

Not sure this is true in all cases.  This would be true in some cases where the difference between say Bronze and Gold plan would be different networks, but a lot of plans have the same networks be it Bronze or Gold or Platinum.  The difference in these cases are more the deductible and max out-of-pocket.  When selecting the plan the Obamacare users should read the fine print on what the network is. 

For a reasonably healthy person the best deal I think is to pick the most expensive Bronze plan.  Usually the network is pretty good but it is a lot less expensive than Gold plans.  The cost sharing would not be great but if you are healthy it is unlikely that you would spend that much out-of-pocket anyway.

[Sbane]

Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.

Insurance is not supposed to be a good deal. It's not an invrstment. It's insurance. It's there to cover your Inks just in case something terrible happens.

And if you are having trouble finding a specialist to treat your cancer, it defeats the purpose.

Also, one can determine value in insurance. It actually is a great deal for those who are old, because their premiums are lower now. Not so much for Obama's base.

[memphis]

Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.

Insurance is not supposed to be a good deal. It's not an invrstment. It's insurance. It's there to cover your Inks just in case something terrible happens.

And if you are having trouble finding a specialist to treat your cancer, it defeats the purpose.

Also, one can determine value in insurance. It actually is a great deal for those who are old, because their premiums are lower now. Not so much for Obama's base.

Obama's base is the working poor. They are getting enormous subsidies. It's an incredible deal for them. And despite the clickbait headline, I don't see any evidence here that people in exchange based plans have more difficulty finding docs than those with employer sponsered plans. These are the same private insurance plans that people get through their employers. Mine is with BlueCross. I doubt the doctor's office even knows that I bought mine on the exchange. There is, in fact, no such product as Obamacare.

[Sbane]

Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.

Insurance is not supposed to be a good deal. It's not an invrstment. It's insurance. It's there to cover your Inks just in case something terrible happens.

And if you are having trouble finding a specialist to treat your cancer, it defeats the purpose.

Also, one can determine value in insurance. It actually is a great deal for those who are old, because their premiums are lower now. Not so much for Obama's base.

Obama's base is the working poor. They are getting enormous subsidies. It's an incredible deal for them. And despite the clickbait headline, I don't see any evidence here that people in exchange based plans have more difficulty finding docs than those with employer sponsered plans. These are the same private insurance plans that people get through their employers. Mine is with BlueCross. I doubt the doctor's office even knows that I bought mine on the exchange. There is, in fact, no such product as Obamacare.

Every plan has its own network, and the premium is priced based on that. Of course there are employer plans with narrow networks as well, but it's a hilariously naive thing to say that all plans by an insurer have the same network. It could be true for a PCP or a hospital, but plans within an insurer will vary when it comes to specialists as their service is more valuable and they have an upper hand in negotiations with insurers. When designing narrow network plans, such as the Obamacare plans, insurers will likely not include a lot of well known and sought after specialists in that network.

Also, Obama's base includes young, single people of all economic backgrounds. The subsidies for these plans aren't so great if you haven't popped out a couple of kids yet.

[memphis]

I never said that all plans by one insurer have the same network. BlueCross of TN has several, and I believe all of them are available on the exchange. My point, and I don't think you get this, is that my network is shared with other insured people and not all of them bought their policies on the exchanges. There are people who have their policies sponsored by their employers who have the exact same network I do. There is no such thing as an Obamacare network. But even if there were, it would be incumbent on you to mathmatically demonstrate that the problems are substantially more severe than for the same population, many of whom had no legit insurance at all, before the ACA. Otherwise, your headline may as well say "Chinese people having trouble finding specialists." In some cases, it may be literally true because it's an issue for everybody, but there is a profoundly misleading issue of connectivity implied.

[AggregateDemand]

One of the reasons Obamacare may be successful in the long run is its ability to kill sick people more efficiently. Republicans tried to avoid this outcome, but alas. People begged for government insurance and rationing.

Godspeed

[Franzl]

One of the reasons Obamacare may be successful in the long run is its ability to kill sick people more efficiently. Republicans tried to avoid this outcome, but alas. People begged for government insurance and rationing.

Godspeed

I'm pretty sure the Republican plan - do nothing - was much more effective at killing sick people. I'm also shocked that there is a serious attempt to dispute this.

[AggregateDemand]

I'm pretty sure the Republican plan - do nothing - was much more effective at killing sick people. I'm also shocked that there is a serious attempt to dispute this.

In order to - do nothing - the legislature must actively persecute private individuals who are trying to solve the problem. No one is being persecuted for solving our healthcare problems, nor have Republicans proposed any such legislation.

The Republican view is not difficult to decipher. If people buy relatively unrestricted healthcare insurance in marketplaces that are free from state-sanctioned monopoly, Americans can tailor their consumptive behavior to buy what they need. The possible exception is some kinds of catastrophic insurance, which cannot be properly priced or administrated by markets.

For reasons no one can gather, Democrats continue to push forward with their inequitable comprehensive health insurance, which is little more than a thinly disguised attempt to redistribute wealth according to arcane moral principles no one can understand. A 50 year old man must by contraceptives for a 20 year old girl. A 20 year old man must cover prostate surgery for a 55 year old man. A 25 year old woman is buying mammograms for a 55 year old woman.

It makes no sense. It has virtually no support in either party, yet this is the bill that Democrats held their noses and passed. Predictably, they were hammered mercilessly in the 2010 midterms for good reason.

[MaxQue]

Healthcare insurance market wouldn't be free, no matter what Washington do.

There isn't enough healthcare insurance providers to create a true free market. It's an oligarchy, which will plot and to secret deals with each other to ramp up the prices.

[Sbane]

I never said that all plans by one insurer have the same network. BlueCross of TN has several, and I believe all of them are available on the exchange. My point, and I don't think you get this, is that my network is shared with other insured people and not all of them bought their policies on the exchanges. There are people who have their policies sponsored by their employers who have the exact same network I do. There is no such thing as an Obamacare network. But even if there were, it would be incumbent on you to mathmatically demonstrate that the problems are substantially more severe than for the same population, many of whom had no legit insurance at all, before the ACA. Otherwise, your headline may as well say "Chinese people having trouble finding specialists." In some cases, it may be literally true because it's an issue for everybody, but there is a profoundly misleading issue of connectivity implied.

Sigh. Some plans are narrow network and some are not. I don't understand why this is so hard for you to get, although I should not be surprised. Even BCBST, who you say is your insurer, has a P network and a S network.

And before you say both networks are available on the exchange, in order to get the better network one must pay more. My point is that even the cheapest plans on the exchange with the crappy network has a high premium and high deductible.

[Antonio the Sixth]

I'm pretty sure the Republican plan - do nothing - was much more effective at killing sick people. I'm also shocked that there is a serious attempt to dispute this.

In order to - do nothing - the legislature must actively persecute private individuals who are trying to solve the problem. No one is being persecuted for solving our healthcare problems, nor have Republicans proposed any such legislation.

The Republican view is not difficult to decipher. If people buy relatively unrestricted healthcare insurance in marketplaces that are free from state-sanctioned monopoly, Americans can tailor their consumptive behavior to buy what they need. The possible exception is some kinds of catastrophic insurance, which cannot be properly priced or administrated by markets.

For reasons no one can gather, Democrats continue to push forward with their inequitable comprehensive health insurance, which is little more than a thinly disguised attempt to redistribute wealth according to arcane moral principles no one can understand. A 50 year old man must by contraceptives for a 20 year old girl. A 20 year old man must cover prostate surgery for a 55 year old man. A 25 year old woman is buying mammograms for a 55 year old woman.

It makes no sense. It has virtually no support in either party, yet this is the bill that Democrats held their noses and passed. Predictably, they were hammered mercilessly in the 2010 midterms for good reason.

And on a "free market" system, people die because they can't afford health insurance. But oh my, paying for someone else is so much worse than letting said someone die!

[jaichind]

And on a "free market" system, people die because they can't afford health insurance. But oh my, paying for someone else is so much worse than letting said someone die!

But on other non-free market systems people also die waiting in line since rationing is the obvious consequence o a non-free market system.  

Besides, we must assign some sort of economic value of life.  We might disagree on what that value is but there must be such an assumed value.  Otherwise we should enforce rules like the speed limit on cars should be 10 miles/per hour which would saves tens of thousands of lives a year.  Once we agree there will have to be a trade off between life and economic cost the debate should then be how to do it more efficiently.  To assert a system is no good because some lives are lost is to ignore this basic reality.  

[Franzl]

But on other non-free market systems people also die waiting in line since rationing is the obvious consequence o a non-free market system.  

The number of those that die "waiting in line" can be kept at a minimum with competent rationing.

Every medical system rations, it's just that the free market rations on ability to pay. (Ignoring the fact that medicine is one area where the economic ideal of a free market is impossible to begin with.)

I'd prefer rationing to be based on actual medical need.

[memphis]

I never said that all plans by one insurer have the same network. BlueCross of TN has several, and I believe all of them are available on the exchange. My point, and I don't think you get this, is that my network is shared with other insured people and not all of them bought their policies on the exchanges. There are people who have their policies sponsored by their employers who have the exact same network I do. There is no such thing as an Obamacare network. But even if there were, it would be incumbent on you to mathmatically demonstrate that the problems are substantially more severe than for the same population, many of whom had no legit insurance at all, before the ACA. Otherwise, your headline may as well say "Chinese people having trouble finding specialists." In some cases, it may be literally true because it's an issue for everybody, but there is a profoundly misleading issue of connectivity implied.

Sigh. Some plans are narrow network and some are not. I don't understand why this is so hard for you to get, although I should not be surprised. Even BCBST, who you say is your insurer, has a P network and a S network.

And before you say both networks are available on the exchange, in order to get the better network one must pay more. My point is that even the cheapest plans on the exchange with the crappy network has a high premium and high deductible.

And this is different than employer sponsered plans because? Restrictive networks are an issue. I agree with you on that. My concern is that you are suggesting it's a problem primarily for the "Obamacare" crowd. Many employers also give a few options with different (subsidized) prices for insurance, even if they are within the same insurer. Before the exchanges were in operation, I had a policy that I bought individually and I also had to choose my network carefully then. What is the specific connection between the ACA and the network issue?  

[AggregateDemand]

And on a "free market" system, people die because they can't afford health insurance. But oh my, paying for someone else is so much worse than letting said someone die!

No one has proposed repealing Medicaid or Medicare, unless they a pitching a new healthcare entitlement.

Your remarks aren't even tangential to the issue. Costs are out of control because our system has virtually no market forces. Government and private companies are basically tag-teaming the American people to see how much money they can squeeze from their pockets before they break.

[AggregateDemand]

Healthcare insurance market wouldn't be free, no matter what Washington do.

There isn't enough healthcare insurance providers to create a true free market. It's an oligarchy, which will plot and to secret deals with each other to ramp up the prices.

Has anyone demanded perfect competition in an unrestricted marketplace? In many states, health insurers have government-sanctioned monopolies or duopolies. Oligopoly would be an improvement.

Furthermore, the economics of insurance require oligopolies in some ways. Small companies cannot effectively bargain or absorb risk. Oligopolies can, but they have to be well-regulated. The regulations are in place (perhaps too many), but the government is restricting access to competition between companies.