Obamacare is a Complete Failure

[Mad Jack]

http://www.nytimes.com/2015/02/08/sunday-review/insured-but-not-covered.html

I'll open by saying idgaf that its real name is the ACA, for anyone that wanted to drop that revelatory piece of information as a follow-up. This abomination deserves to be named after its insistent creator, so I'm sticking with it. Now, why does it suck?

Insurers may be forced to enroll people, but that doesn't mean they'll actually get coverage. To limit their costs, insurers have been pruning their coverage networks to a ridiculous degree- something they'd planned on doing before Obamacare, but accelerated once it became law. Premiums are still growing faster than wages, and patients are paying more out of their own pockets than ever before. The sorts of people that the exchange was designed to help most (those with expensive preexisting conditions) find themselves unable to access the specialists and hospitals that are best equipped to handle their conditions.

Patients have less options and coverage than before the law, higher premiums, and much higher out of pocket fees. Physicians are seeing lower reimbursement or no reimbursement at all due to network exclusion, as well as less mobility due to the inability of many specialists to enroll in provider networks, and of course there is the ever decreasing autonomy as new docs are forced to be employees due to the high costs of mandatory EMR and billing coupled with the difficulty of gaining access to a provider network as a solo practitioner.

Who won? Insurance companies and drug companies. Maybe a dem or two that can say they delivered on one of their promises while lying through their teeth. Patients lose. Hospitals lose. Doctors lose. Obamacare is a failure of epic proportions, and one that has likely caused a degree of damage that can never be undone, even by repeal, because insurers have realized what they can get away with and aren't likely to go back to their old ways.

The biggest reason we should all care is that this is the market we might be graduating into. One where you can be an ENT doc that can't find an insurance company willing to add you to their panel, so you're forced to take an employed position with a hospital group or nothing. One where you can be a PCP that is forced to send your patient to a city four hours out because the only specialist your insurance company covers in the county happens to be there.

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[moonwake]

My brother in-law just graduated law school and is working and was placed on obamacare. He says the premiums aren't cheap and the deductible is ridiculously high ($5000?) I don't remember exactly. So he ends up paying out of pocket for everything. I have a friend who is on medicaid and wants to pay for health insurance (obamacare) but they said they won't let her because she doesn't make enough money and she has to go on welfare- literally they used the words "have to" as if she had no other option. I wanted to have obamacare too but I ended up just getting some lame catastrophic insurance because I never get sick and I can save on the premiums. However... obamacare is not helping anyone and I seriously think it's a new scheme to help pay off our 4 trillion dollar debt.

EDIT: just found an article with the exact amounts - which are awful....

"HealthPocket found that the average deductible for an individual enrolled in a bronze plan in 2015 will be $5,181, or $100 more than 2014 limits. For families in bronze plans, the deductible next year will be $10,545, or $159 more than this year.

For individuals in silver plans in 2015, they'll have average deductibles of $2,927, or $20 more than this year. The average deductibles for families in silver plans next year will actually decrease by $68, to $6,010.

While HealthPocket didn't see big hikes in the average deductible limits, Coleman noted, "Those are very high amounts" for people to have to pay."

http://www.cnbc.com/id/102204181#.

 

[Psai]

Don't be so naive. Obamacare is working perfectly and doing exactly what it was intended to do, for the people it was for. It's just like the bank bailouts which didn't help the people who needed help and served as one of the largest transfers of wealth to the wealthy in recent history. You don't honestly think that politicians care about the welfare of the general public, do you? That don't put money in their pacs

 

[moonwake]

Don't be so naive. Obamacare is working perfectly and doing exactly what it was intended to do, for the people it was for. It's just like the bank bailouts which didn't help the people who needed help and served as one of the largest transfers of wealth to the wealthy in recent history. You don't honestly think that politicians care about the welfare of the general public, do you? That don't put money in their pacs

True and I've never had faith in politicians. But come on we're going into healthcare which basically means we're watching it die a slow painful death. What else can I do to voice my objection? And don't say vote... I don't have faith in that anymore either .

 

[Psai]

Don't take call, don't accept ****ty jobs and when you find an acceptable workplace, just do your job and go home.

 

[Mad Jack]

Don't take call, don't accept ****ty jobs and when you find an acceptable workplace, just do your job and go home.

I plan to be my own boss and not accept insurance, personally.

 

[moonwake]

I plan to be my own boss and not accept insurance, personally.

Do you know a lot of doctors that can actually survive that way and not comply with medicaid laws and all that? I know of a few hospitals in CA that do that I think but mainstream it's almost impossible no?

 

[Mad Jack]

Do you know a lot of doctors that can actually survive that way and not comply with medicaid laws and all that? I know of a few hospitals in CA that do that I think but mainstream it's almost impossible no?

I'm going to be a psychiatrist. Half of psychiatrists don't accept insurance at all and most are solo practitioners.

 

[moonwake]

I'm going to be a psychiatrist. Half of psychiatrists don't accept insurance at all and most are solo practitioners.

Lucky you... lol. So I guess there are plastic surgeons and psychiatrists. What other specialties can get away with that without significantly losing salary?

 

[Roxas]

Lucky you... lol. So I guess there are plastic surgeons and psychiatrists. What other specialties can get away with that without significantly losing salary?

Family med. Find a wealthy enough area and set up a concierge practice, could be a pretty sweet gig.

 

[moonwake]

Family med. Find a wealthy enough area and set up a concierge practice, could be a pretty sweet gig.

Royal pains much haha

 

[ajh1983]

Lucky you... lol. So I guess there are plastic surgeons and psychiatrists. What other specialties can get away with that without significantly losing salary?

I think you need to look at it the other way around. There are only a handful of specialties that can't operate outside of insurance. EM docs would be tough, onc, few others.

I personally have turned my focus away from matching surgical and toward primary care BECAUSE of the enormous opportunities out there right now in direct primary care... and because of the scary career prospects once you tie yourself to a hospital. Lose salary? No, how about double it, easy. High priced concierge only for the rich? Just the opposite. Patients pay an average of $60 per month for comprehensive, quality primary care. It's an exciting time to be a medical student/resident/doc. I see it as we will be rebuilding care from the ground up, because the top down model sure has failed us.

 

[Frazier]

Lucky you... lol. So I guess there are plastic surgeons and psychiatrists. What other specialties can get away with that without significantly losing salary?

Family med. Find a wealthy enough area and set up a concierge practice, could be a pretty sweet gig.

Right.

I think there is a spectrum of namely 2 factors that make cash PP possible. If a specialty can make it onto the spectrum, then they have a chance in the payment model.

The factors (not groundbreaking):

1) Overhead (OH)
2) Well-off patients (WP)

On one end of the spectrum stick [low] OH and on the other end the WP.

OH====================WP

Psych obviously falls on the left (as it has the lowest OH in all of medicine). You could theoretically keep your business afloat by working less than 1 hour per day at current market rates. Of course, you yourself would be in poverty, but I'm just talking practice health.

Plastics with their ability to accommodate a cosmetics market falls toward the right. Any surgical specialty is going to have some heavy OH, but the concentration of wealthy people that want your services and are willing to pay $$$ often takes care of that OH and then some.

FM falls somewhere in the middle. All people need a family doc (whether they have one or not is a different story), no different the WP need a PCP. Obviously less WP are likely going to be willing to pay cash for PCP services, but the fact that FM has lower OH than plastics, it turns out to not be a huge problem in the right markets. The OH in FM can be kept within a reasonable range, not a super pricey office, avoid extraneous staff, avoid wasted materials, establish ways to ensure full and prompt payment, etc.

So our spectrum [filled in] looks something like:

OH=Psych=====FM====PS=WP

If you want to think of any other specialties that can support the cash-pay PP model, simply see if they fall on the above spectrum and where. It is an approximation tool and a crude approach, but it gives a good idea of what's what.

 

[Mad Jack]

I think you need to look at it the other way around. There are only a handful of specialties that can't operate outside of insurance. EM docs would be tough, onc, few others.

I personally have turned my focus away from matching surgical and toward primary care BECAUSE of the enormous opportunities out there right now in direct primary care... and because of the scary career prospects once you tie yourself to a hospital. Lose salary? No, how about double it, easy. High priced concierge only for the rich? Just the opposite. Patients pay an average of $60 per month for comprehensive, quality primary care. It's an exciting time to be a medical student/resident/doc. I see it as we will be rebuilding care from the ground up, because the top down model sure has failed us.

With the coverage issues I noted in my OP, I predict direct primary care to be quite a fruitful industry in the future. Most plans have deductibles of between 3-5k/year for an individual and 6-10k per year for a family, and severely limit providers. By signing up at a DPC practice, families can actually save money and have convenient access to care by bypassing their insurer's provider network entirely. For $600/year for an individual adult and $120/year for an individual child, you can enroll your entire family for comprehensive outpatient services and save 80-90% on imaging, bloodwork, and other tests, and likely come in far below your plan's deductible. Plus, by enrolling in a DPC practice, you can afford to select a lower level of coverage, saving your family potentially thousands on insurance premiums that more than make up for the cost of the yearly retainer fees.

 

[PikminOC]

My brother in-law just graduated law school and is working and was placed on obamacare. He says the premiums aren't cheap and the deductible is ridiculously high ($5000?) I don't remember exactly. So he ends up paying out of pocket for everything. I have a friend who is on medicaid and wants to pay for health insurance (obamacare) but they said they won't let her because she doesn't make enough money and she has to go on welfare- literally they used the words "have to" as if she had no other option. I wanted to have obamacare too but I ended up just getting some lame catastrophic insurance because I never get sick and I can save on the premiums. However... obamacare is not helping anyone and I seriously think it's a new scheme to help pay off our 4 trillion dollar debt.

EDIT: just found an article with the exact amounts - which are awful....

"HealthPocket found that the average deductible for an individual enrolled in a bronze plan in 2015 will be $5,181, or $100 more than 2014 limits. For families in bronze plans, the deductible next year will be $10,545, or $159 more than this year.

For individuals in silver plans in 2015, they'll have average deductibles of $2,927, or $20 more than this year. The average deductibles for families in silver plans next year will actually decrease by $68, to $6,010.

While HealthPocket didn't see big hikes in the average deductible limits, Coleman noted, "Those are very high amounts" for people to have to pay."

http://www.cnbc.com/id/102204181#.

How's that hope and change working out for you?

 

[moonwake]

How's that hope and change working out for you?

Sorry- I guess I'm not sure what you mean.

 

[PikminOC]

Sorry- I guess I'm not sure what you mean.

http://lmgtfy.com/?q=obama+hope+and+change

 

[ModyzMalak]

How's that hope and change working out for you?

Lol I like what you did there

 

[moonwake]

http://lmgtfy.com/?q=obama hope and change

lol yeah- him being elected was proof enough that the system was failing.

 

[SpinalFusion]

I really like that DPC model, but what do your patients do when they need a service that your practice can't provide and they've already blown their wad buying into your practice?

 

[Mad Jack]

I really like that DPC model, but what do your patients do when they need a service that your practice can't provide and they've already blown their wad buying into your practice?

They go into their insurance's provider list. Given the money they save on copays and deductibles on a year-over-year basis with DPC over utilizing their insurance's providers and services, they'll probably come ahead in the end regardless.

 

[DoctwoB]

A lot of people drinking the haterade here. I needed some short term coverage after I could no longer be on my parents plan. As a young, healthy person I found a great plan for me. low pcp visit copays, high deductible for less then 100/month (school insurance was 240/month). True the rollout was botched and it just scratched the surface of issues in American health care, but if you think anything more comprehensive was getting passed you're kidding yourself.

Also, just as an fyi. Regardless of your politics, blanket statements like "it's all Obama's (or bush's) fault" come across as ignorant and puerile. Our health system is complex and exists over the setting of a complex and flawed political system. It's almost never the simple answer . . .

 

[maxxor]

A lot of people drinking the haterade here. I needed some short term coverage after I could no longer be on my parents plan. As a young, healthy person I found a great plan for me. low pcp visit copays, high deductible for less then 100/month (school insurance was 240/month). True the rollout was botched and it just scratched the surface of issues in American health care, but if you think anything more comprehensive was getting passed you're kidding yourself.

The question is, did you try to use the insurance you had purchased? That's primarily what the article is saying. Sure, it's easier to get "coverage", but when push comes to shove and you need services, can you actually get them? Evidence appears that it's harder than ever and that people would do better to simply bypass the insurance system and pay cash.

 

[Roxas]

A lot of people drinking the haterade here. I needed some short term coverage after I could no longer be on my parents plan. As a young, healthy person I found a great plan for me. low pcp visit copays, high deductible for less then 100/month (school insurance was 240/month). True the rollout was botched and it just scratched the surface of issues in American health care, but if you think anything more comprehensive was getting passed you're kidding yourself.

Also, just as an fyi. Regardless of your politics, blanket statements like "it's all Obama's (or bush's) fault" come across as ignorant and puerile. Our health system is complex and exists over the setting of a complex and flawed political system. It's almost never the simple answer . . .

You're right, it's not "all" one person's fault. But you're delusional if you think that Obama (and a good number of his party) didn't fight tooth and nail to ram healthcare reform through.

 

[Detective John McClane]

With the coverage issues I noted in my OP, I predict direct primary care to be quite a fruitful industry in the future. Most plans have deductibles of between 3-5k/year for an individual and 6-10k per year for a family, and severely limit providers. By signing up at a DPC practice, families can actually save money and have convenient access to care by bypassing their insurer's provider network entirely. For $600/year for an individual adult and $120/year for an individual child, you can enroll your entire family for comprehensive outpatient services and save 80-90% on imaging, bloodwork, and other tests, and likely come in far below your plan's deductible. Plus, by enrolling in a DPC practice, you can afford to select a lower level of coverage, saving your family potentially thousands on insurance premiums that more than make up for the cost of the yearly retainer fees.

Looks like the age of the house call is coming back. I'm not opposed.

 

[moonwake]

You're right, it's not "all" one person's fault. But you're delusional if you think that Obama (and a good number of his party) didn't fight tooth and nail to ram healthcare reform through.

Pretty much.

 

[ChiDO]

A lot of people drinking the haterade here. I needed some short term coverage after I could no longer be on my parents plan. As a young, healthy person I found a great plan for me. low pcp visit copays, high deductible for less then 100/month (school insurance was 240/month). True the rollout was botched and it just scratched the surface of issues in American health care, but if you think anything more comprehensive was getting passed you're kidding yourself.

Also, just as an fyi. Regardless of your politics, blanket statements like "it's all Obama's (or bush's) fault" come across as ignorant and puerile. Our health system is complex and exists over the setting of a complex and flawed political system. It's almost never the simple answer . . .

You could get this before Obamacare and probably for cheaper. When I lost my parents coverage in medical school, I found basically a catastrophic insurance plan. $5k deductible, free yearly check up, $5 co-pay PCP, $10 specialists for $80/month. Compared to the med school plan for $200+/month.

 

[ajh1983]

I really like that DPC model, but what do your patients do when they need a service that your practice can't provide and they've already blown their wad buying into your practice?

If you're truly interested, run the numbers for yourself and see how even if a patient has to eat his/her 5k deductible every 3 years, they still save money with better care.

If you're arguing, then nothing I say will change your mind anyway.

I'm not kidding either, run the numbers and see how people would actually spend on yearly care thats leagues above what insurance can provide in quality. I was blown away when I started researching DPC 2 years ago.

 

[jqueb29]

Do you know a lot of doctors that can actually survive that way and not comply with medicaid laws and all that? I know of a few hospitals in CA that do that I think but mainstream it's almost impossible no?

With a enough experience and enough capital, it's very easy to start your own group that contracts to hospital(s). Hospital has to deal with the hassle of insurance/medicare/medicaid payments, while you have a set-in-stone contract guaranteeing you get yours with no fuss.

 

[charmiedermie]

A lot of people drinking the haterade here. I needed some short term coverage after I could no longer be on my parents plan. As a young, healthy person I found a great plan for me. low pcp visit copays, high deductible for less then 100/month (school insurance was 240/month). True the rollout was botched and it just scratched the surface of issues in American health care, but if you think anything more comprehensive was getting passed you're kidding yourself.

Also, just as an fyi. Regardless of your politics, blanket statements like "it's all Obama's (or bush's) fault" come across as ignorant and puerile. Our health system is complex and exists over the setting of a complex and flawed political system. It's almost never the simple answer . . .

Have u actually had to use your plan, or have u just been paying premiums? Anyone can pay premiums.

 

[AM508]

Ugh...Too true. All portents point to it being a disaster. I know in my case, my health insurance was cancelled (so much for liking ones plan and keeping it eh?), I tried to go on the exchange...it was a mess and and in the end all it wanted to do was send me to medicaid (not useful as my doctors do not take medicaid) ...I ended up having to get a plan not on the the exchange and, while its coverage is good, the monthly cost is high and so is the deductible.

 

[DoctwoB]

Have u actually had to use your plan, or have u just been paying premiums? Anyone can pay premiums.

I used it for routine preventative care and had no problems. Fortunately I never had to test out the hospital benefits. It was a narrow-network plan but included the major hospital network in my city.

 

[DoctwoB]

You could get this before Obamacare and probably for cheaper. When I lost my parents coverage in medical school, I found basically a catastrophic insurance plan. $5k deductible, free yearly check up, $5 co-pay PCP, $10 specialists for $80/month. Compared to the med school plan for $200+/month.

I understand that. The ACA didn't invent individual health insurance. It just created a marketplace for competing plans, set minimum standards (which would increase costs on the cheapest plans) and put in the individual mandate.

 

[charmiedermie]

I used it for routine preventative care and had no problems. Fortunately I never had to test out the hospital benefits. It was a narrow-network plan but included the major hospital network in my city.

Then thats not really that impressive. Health insurance power really kicks in for something catastrophic - car accident, cancer, major surgery, etc. That's when you really appreciate how comprehensive your benefits are and how much you're affected by narrow networks.

 

[charmiedermie]

I understand that. The ACA didn't invent individual health insurance. It just created a marketplace for competing plans, set minimum standards (which would increase costs on the cheapest plans) and put in the individual mandate.

You could do the same thing by comparing plans yourself manually by going to company websites. What exactly did u gain?

 

[Stagg737]

You could do the same thing by comparing plans yourself manually by going to company websites. What exactly did u gain?

What you supposedly gain is a way to better afford healthcare premiums through tax reimbursements/expansion of medicaid at the cost of patient autonomy and networks that weren't thinner than thread. In my case I ended up being unable to qualify for any of that, so the ACA literally did nothing for me other than allow me to stay on my parent's insurance for an extra year, which has saved me nothing since the premiums for the same plan I am on now (one I had to find myself because I wasn't covered through the marketplace) would have been significantly cheaper before Obamacare. Yea, there are some good parts of the bill, but overall it's basically been a disaster and probably won't be getting any better for anyone it' supposedly helps.

Also, I think most people here are forgetting that the average American isn't bright enough to understand that the ACA didn't actually provide coverage to everyone, let alone figure out that it's cheaper to not use their insurance...

 

[pd1112]

Not defending ACA, but after reading 3 paragraphs of OP's linked article - how entitled are patients today? God forbid she had to drive 14 (!!!!!!!!!!!!!!!!!) miles to see a specialist in her network that she could've (I'm assuming) known about through minimal effort on her part before she signed up. It's in another state too?! Add on more hours for the time it takes to get through interstate border patrols and security checks plus the emotional despair that comes with crossing state lines. If we're paying for insurance, there best be a doctor with an x-ray machine and cast either at the scene to treat us or at our home within a day should we trip and hurt ourselves.

 

[maxxor]

Not defending ACA, but after reading 3 paragraphs of OP's linked article - how entitled are patients today? God forbid she had to drive 14 (!!!!!!!!!!!!!!!!!) miles to see a specialist in her network that she could've (I'm assuming) known about through minimal effort on her part before she signed up. It's in another state too?! Add on more hours for the time it takes to get through interstate border patrols and security checks plus the emotional despair that comes with crossing state lines. If we're paying for insurance, there best be a doctor with an x-ray machine and cast either at the scene to treat us or at our home within a day should we trip and hurt ourselves.

She lives in Manhattan and most likely doesn't have a car. It seems silly for an insurance network in Manhattan to have no orthopedists on the island in network. It almost seems intentional that they would only have people prohibitively far away so as to discourage utilization.

 

[AM508]

She lives in Manhattan and most likely doesn't have a car..

Not to mention the fact that 14 miles in NYC is not equivalent to 14 miles in suburbia and can take a huge amount of time.

 

[Mad Jack]

Not defending ACA, but after reading 3 paragraphs of OP's linked article - how entitled are patients today? God forbid she had to drive 14 (!!!!!!!!!!!!!!!!!) miles to see a specialist in her network that she could've (I'm assuming) known about through minimal effort on her part before she signed up. It's in another state too?! Add on more hours for the time it takes to get through interstate border patrols and security checks plus the emotional despair that comes with crossing state lines. If we're paying for insurance, there best be a doctor with an x-ray machine and cast either at the scene to treat us or at our home within a day should we trip and hurt ourselves.

People in manhattan don't have cars, dude, and public transportation only runs so far. That her insurance covers zero orthopedists on the entire island of Manhattan with its millions of people and hundreds of orthopedists is freaking ridiculous.

 

[Psai]

Not defending ACA, but after reading 3 paragraphs of OP's linked article - how entitled are patients today? God forbid she had to drive 14 (!!!!!!!!!!!!!!!!!) miles to see a specialist in her network that she could've (I'm assuming) known about through minimal effort on her part before she signed up. It's in another state too?! Add on more hours for the time it takes to get through interstate border patrols and security checks plus the emotional despair that comes with crossing state lines. If we're paying for insurance, there best be a doctor with an x-ray machine and cast either at the scene to treat us or at our home within a day should we trip and hurt ourselves.

Damn you are dumb as hell. 14 miles is a significant drive for someone in Manhattan where the majority of people take public transportation or taxis. Bridges cost an arm and a leg to cross. It doesn't take minimal effort to figure anything out these days, you call a company and you get some random person in India who doesn't know a thing. The concept of a network is an abomination.

There are four medical schools in Manhattan. There is one in the Bronx, one in Brooklyn, one on long island, one in new jersey and they all have a ton of docs. It makes absolutely no sense for someone to have to go to connecticut if you have twenty orthopedic surgeons in spitting distance of your house

I dislike entitled patients but this is not even close to an example of that

 

[BrooklynBulls]

About 1.3 million people in 13 square miles and not one orthopod to serve them is patently ridiculous. Why isn't there one? Because those orthopods charge for insane manhattan rent.

 

[pd1112]

Point taken, I admittedly never considered NYC residents would not even own a car. That being said, it almost supports the notion of entitlement. Is it too much to ask to spend 5 minutes to look into the network before signing up? Isn't that the whole point of the website, so you can "shop and compare?"

 

[RNCasey]

RN case manager here, I set up the discharge therapies for an orthopedic surgical floor. Obamacare plans are next to useless when arranging standard post op care. Equipment and therapy companies frequently return with ridiculous fees to arrange care for these plans, if they can accept them at all. Fees that patients can't often pay or they assume they will have already paid with their hospital deductible. Just because their premiums or annual costs didn't increase doesn't mean patients are not extremely vulnerable with these plans.

 

[pd1112]

Damn you are dumb as hell. 14 miles is a significant drive for someone in Manhattan where the majority of people take public transportation or taxis. Bridges cost an arm and a leg to cross. It doesn't take minimal effort to figure anything out these days, you call a company and you get some random person in India who doesn't know a thing. The concept of a network is an abomination.

There are four medical schools in Manhattan. There is one in the Bronx, one in Brooklyn, one on long island, one in new jersey and they all have a ton of docs. It makes absolutely no sense for someone to have to go to connecticut if you have twenty orthopedic surgeons in spitting distance of your house

I dislike entitled patients but this is not even close to an example of that

So she had no other choice than the plan with the closest orthopaedist in Connecticut? If so, you're right, I'm dumb as hell. I hate the ACA and insurance companies just as much as everyone else in here. I am 0% defending either. But you'd think that would be 1 of the first things someone without a car would look for in an insurance plan - which places are covered that I can reasonably get to.

 

[BrooklynBulls]

Point taken, I admittedly never considered NYC residents would not even own a car. That being said, it almost supports the notion of entitlement. Is it too much to ask to spend 5 minutes to look into the network before signing up? Isn't that the whole point of the website, so you can "shop and compare?"

How on earth does that support the notion of entitlement? There is no car because it is WILDLY expensive to operate one in manhattan. Monthly parking is at least 400 dollars, and at most 800. Insurance is high. Gas costs are high. Mechanics are super expensive in the borough. Street parking is nearly impossible and garage parking is easily 10 dollars an hour.

Welcome to New York City.

And are you supposed to check availability of every known type of specialist before you sign up? Because I, a medical student, didn't even do that. How is Joe Schmoe supposed to be expected to?

 

[pd1112]

RN case manager here, I set up the discharge therapies for an orthopedic surgical floor. Obamacare plans are next to useless when arranging standard post op care. Equipment and therapy companies frequently return with ridiculous fees to arrange care for these plans, if they can accept them at all. Fees that patients can't often pay or they assume they will have already paid with their hospital deductible. Just because their premiums or annual costs didn't increase doesn't mean patients are not extremely vulnerable with these plans.

All good points, and just more flaws to add onto the list, but from the story it seems like she just needed non-operative outpatient Tx.

 

[Mad Jack]

So she had no other choice than the plan with the closest orthopaedist in Connecticut? If so, you're right, I'm dumb as hell. I hate the ACA and insurance companies just as much as everyone else in here. I am 0% defending either. But you'd think that would be 1 of the first things someone without a car would look for in an insurance plan - which places are covered that I can reasonably get to.

You don't understand. Most of the time the provider networks are nebulous, even after you sign up. Furthermore, people often don't know what specialists they'll need. So they pick a plan that works for them now, but oh *snap* (literally) you broke your tibia and need an ortho. You never considered it before, because you're an average dumb consumer that didn't plan on making sure every one of the 40+ specialties of medicine was available in your immediate area, by looking through plan after plan tediously for each specialty one by one.

It isn't a user friendly system. It is designed to screw consumers.

 

[Ismet]

But you'd think that would be 1 of the first things someone without a car would look for in an insurance plan - which places are covered that I can reasonably get to.

You give people way too much credit.

 

[notbobtrustme]

america's healthcare is ****ed, more at 11

this is exactly zero news to anyone who has an inkling of what a successful health plan looks like in every other developed country.