Thursday, November 21, 2013

Restricting Doctor and Hospital Choice With Obamacare: Feature or a Bug?

Damn! It's not in my provider network! (Neither are its costs.)

It's a feature! Of course, in today's WaPo there's an article entitled, "Insurers restricting choice of doctors and hospitals to keep costs down," which is a tad bit misleading. It's full of mostly factual stuff but then pulls at the heartstrings with anecdotes like this:
But as a result, families like Jeffrey Blank’s, which has relied on Seattle Children’s since his daughter, Zoe, received a diagnosis of a rare bone disorder, face difficult decisions. Under some of the new law’s health plans, the family would no longer be able to take Zoe to Children’s for her routine checkups, or it could count as an “out-of-network” visit, saddling the family with huge bills.
“It just stresses me,” said Blank, 53, a self-employed massage therapist who is sorting through his options but readily admits that his family has benefited from other parts of the health law. “I hope things continue wonderfully for my daughter and that she doesn’t need the level of care she got after her diagnosis, but there’s this unknown.”
I feel for the Blanks, I really do, except I don't. I've kept my healthcare costs down for years by, one, getting a job that provided healthcare and, two, choosing Kaiser, which is as close to socialized medicine as one is likely to see in the U.S. I had a choice of, er, Kaiser hospitals, except when I didn't, like when I needed Mohs surgery and I had my choice of Kaiser Vacaville or Kaiser Vacaville. I'm cured, and even though the doc took a hunk the size of a nickel out of my cheek, nowadays I have to strain to see where it was, the unskilled bastard.

Point is, I didn't need the Mayo or the Cleveland, and there are real costs savings in that. For instance, same WaPo article:
In Seattle, the region’s predominant insurer, Premera Blue Cross, decided not to include the children’s hospital as an in-network provider except in cases where the service sought cannot be obtained anywhere else. “Children’s non-unique services were too expensive given the goal of providing affordable coverage for consumers,” spokesman Eric Earl­ing said in an e-mail.
For example, a pediatric appendectomy at Children’s costs about $23,000, he said. At another community hospital, the cost is closer to $14,100. Melzer said his hospital often bills more than community hospitals for comparable procedures because the children it treats are often gravely ill, so even a routine tonsillectomy may be more complicated.
So, Obamacare is already at work saving us money. And, no, this isn't death panels. It's common-sense cost savings, the way it's supposed to be.

And don't forget that when it's one of the Republican talking points you'll be hearing ad nauseum the next several months as they go about trying to ruin the ACA.

John Boehner says "premiums are soaring." What do you expect he'd say?

Update. Let me slip in some graphs (via Krugman) from the Council of Economic Advisors that show more correlation between Obamacare and healthcare costs declining:

And one more that shows how reducing overpayments to Medicare can actually improve outcomes, as measured in hospital readmission rates:

Data aside, Obama is still out to destroy the world as we know it.

Update 2. If Medicare gets more cost-effective and the date certain in the future when it's going to go broke keeps receding, do we still have to slash entitlements? Of course! Obama didn't slash spending enough. He's a communist!

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