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Care versus Coverage

America has always been excellent at providing medical care, but not very good at providing coverage. Obamacare has turned that around.

by
Stephen Green

Bio

January 20, 2014 - 10:35 pm
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News of what might be Obamacare’s most serious medium-term failing came to me thirdhand. Longtime Sharp VodkaPundit Reader™ cfbleachers alerted me to a Neo-Neocon column based on a Washington Examiner “Watchdog” article by PJM alumnus Richard Pollock. There is so much slow-motion fail built into the 2,000 page law, and so little of it is covered in depth by the mainstream media, that thirdhand is often the only way to learn what’s really happening — and what is yet to come.

First, the beef from Pollock:

Former New York Lt. Gov. Betsy McCaughey, a Republican who is now a health care advocate, said Obamacare’s lack of first-class hospitals is a big problem.

“It’s not just the number, but who they are. You’ll find under the Obamacare exchanges that the academic hospitals have declined to participate, along with the specialists who practice at those hospitals. The same is true of cancer hospitals,” she said.

“People who are seriously ill need to stay away from these exchange plans,” McCaughey said.

I need everyone reading this to fully understand the implications of what McCaughey said, so I’m going to spell this out for you bluntly. The only way to receive an Obamacare subsidy is to buy insurance through one of the state exchanges or through Healthcare.gov. But doing so will automatically exclude each and every ACA buyer from the nation’s top hospitals and specialists. In other words, the very people who were supposed to be receiving all the wondrous benefits of the “Patient Protection and Affordable Care Act” will instead be relegated to second- or third-class care. Not to mention higher deductibles.

From there, as difficult as this might be to imagine, things get worse. Let’s go to Neo-Neocon herself:

For those with employer-based insurance, they can stay away (for now—we’ll see how that changes next year). Employer-based plans still have good networks. But people without employer-based insurance who must seek individual policies don’t for the most part have access to those networks, they only have access to the more narrow Obamacare networks.

You might say, “But what of people who buy individual insurance off the exchanges? Can’t they circumvent the problem?” After doing a lot of research (including phoning insurance companies), everything I’ve read and heard points to the fact that the entire individual health insurance business has restructured itself to conform with Obamacare, and that individual policies off the exchanges are the exact same policies as those on the exchanges.

The emphasis is in Neo-N’s original, but at this point it almost seems superfluous, like worrying about the chance of rain during a volcano eruption.

Comments are closed.

Top Rated Comments   
I begin to understand your problem now Stephen, you value substance over image. Haven't you realized yet, this administration is all about the image, substance is irrelevant. How absolutely primeval of you to want substance.
/sarc
26 weeks ago
26 weeks ago Link To Comment
Care vs. coverage. Why in the world can't the Republicans think like this?
26 weeks ago
26 weeks ago Link To Comment
I'm as proud of being a Longtime Vodkapundit Reader (sharp, I'm sure would spark an OT debate) as anything in current bio facts.

Care vs coverage is a brilliant contrast.

Especially since coverage appears to be a mirage. When(not if) employer coverage begins to evaporate in the fall of this year (the extension is scheduled to end in 2015, but employers whose plans do not qualify under the monstrous rules will have to begin eliminating the headache months ahead of time), then the IRS run Proctors Without Borders will set in motion Quack Dynasty in earnest.

The "subsidized" will have "coverage", the uncovered will have penalties...er...a tax...or whatever the cabal's Supreme Court lawyers are calling the IRS "special attention" in those coming days.

Quack Dynasty will have long waits for those bottom half of the class graduates from Gosnell University of Outer Mongolia.

Proctors Without Borders will be political hacks determining whether you can pass your gallstones by "toughing it out", and judging their past history of who gets a little "tighter scrutiny"...if you aren't a PARTY donor, expect to bend over for a little proctorology.

No good doctors and no good hospitals and no good healthcare decisions...just...sit down, shut up and pay for the "subsidized". Now, look to your LEFT...and cough.
26 weeks ago
26 weeks ago Link To Comment
All Comments   (32)
All Comments   (32)
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I've said for years that the goal here was to turn the health care system into a second version of the education system that we have now. There will be a cheap nationalized system that everyone must participate in, which will be staffed by a very large workforce represented by a humungous union, which supports the Democratic party. Those Democrats in public office won't go near the system themselves, except to collect campaign contributions: there's a separate, private system for those with enough money, and of course every Dem will be in it. The scandal will be, if it ever comes out, when the guy who's the administrator of the cheap hospital where the poor people go turns out to have a health care plan that sends *him* and his family members to a better hospital, run by experts.

A 2-tier system, where everyone's equal, but some are more equal than others, seems so much better than our current system, don't you think?
26 weeks ago
26 weeks ago Link To Comment
Good article and good comment. What seems to be coming out here is that the top hospitals are not covered by the Obamacare plans and I think you are seeing the implications clearly. There has been much concern on the right that the goal of the bill is single payer. I'm more convinced by your interpretation mostly because a system such as the one you describe is very familiar to me as an American long resident in Australia. (Wretchard is in similar circumstances has had some commentary on the Australian system versus the ACA). We have a public system here that covers everybody also called Medicare and we even have Medicare cards just like Bill Clinton was waving around. But we all pay a separate Medicare Levy on top of our income tax - so we know where the money comes from. If the US simply dropped the age criteria from Medicare and attached a tax to it for all but the poorest you have a similar system structurally at least. You get treatment in any public hospital, no choice of doctor. And yes there are waiting lists, but the emergency rooms are seldom as backed up as in the US. Then we have private hospitals for which we buy insurance and we get choice of doctor and various levels of accommodation - shared and private room. My premium at age 70 and single is $2000 with a $250 yearly deductible. Our system costs about half the US system as a percentage of GDP in part because we have competition between the two systems. Crudely, if premiums get too high people drop their insurance and rely on the public system and if the waiting lists get too long people buy insurance. Australia's health outcomes are very similar to America's - it is the costs that are the big difference. So seen through the leans of my Australian Healthcare experience I see the ACA trying to create an insurance based 'public tier'. I agree that is going to anger everyone who has to absorb a rate increase or high deductible or both compared to their previous coverage. The fate of the top hospitals like the Mayo Clinic isn't clear to me at this point but I know perfectly ordinary middle class Americans who currently are very happy indeed with the treatment they receive at the Mayo Clinic and I have no idea where they get their insurance and if their coverage will be disrupted, but I do know they will be really upset if they are forced to accept inferior care. This is a problem created by one party, but it is going to take a village to fix it. In the end a bipartisan effort.
25 weeks ago
25 weeks ago Link To Comment
So, what happens if the ACA policies make money for those who participated. There might be some additional participation. There is nothing worth while in the current groups of cottage industries, cobbled together with bare minimum of communication and coordination. Those complaining about anything else, such as Obamacare, are not paying attention to the world as it is
26 weeks ago
26 weeks ago Link To Comment
Just say no. Stop smoking, cut back on the booze, lose weight, get some exercise, eat more basic food and less salt and preservatives, don't do drugs, stop speeding, don't get in fights, try to relax. You'll live past 80 without a doctor's snake oils. Get the cheapest policy you can and save what you would have spent on the high-cost policy; put it in a special account that is for health spending only. Use it later when you need it. Do that for a few decades and you will have a very nice health emergency fund.

They aren't trying to help you, so you better help yourself.
26 weeks ago
26 weeks ago Link To Comment
proreason, This is PRECISELY what my Hubby & I decided to do. Our new "O'Drama-scare" plan costs $1 more per month, but it's a crummy HMO, whereas our old plan (cancelled 12/31/13) was a good PPO. We couldn't afford an equivalent plan for an additional $350.00 per month, since Hubby is self-employed & therefore has an unpredictable income. so we are creating a new "wellness care budget" . This will include our health care premiums, organic food, gym membership, vitamins & whatever else we can afford to pursue "wellness" which is our actual goal anyway.
26 weeks ago
26 weeks ago Link To Comment
Due to the shortage of primary doctors (which will be worse under Obamacare), people will "enjoy" long waiting periods to see a doctor. And due to the limited number of doctors on the plans, we'll be worse off than Canadians are now. They at least have ample numbers of primary care doctors if not enough specialists. We won't have either under Obamacare!
26 weeks ago
26 weeks ago Link To Comment
muskegonlibertarian, my Mom-In-Law is A Canadian & her Primary Care Doc retired, so she is on a LONG waiting list to get a new one. When enough people either die or move away, she will have a new Primary. In the meantime, she has to use the "walk in clinics", (like our Urgent Care Centers).
26 weeks ago
26 weeks ago Link To Comment
The other line that's been blurred into extinction is the once categorical difference between healthcare and insurance.

That conflation did not begin with this President, but it was absolutely essential to the bait and switch Obamacare marketing strategy. Obama's opening pitch was all about insurance and reforming the insurance (racketeering!) industry. Then came the pivot. The whole, inconvenient, concept of catastrophic insurance was consigned to the dust bin of history, of course; it was now all about basic healthcare and healthcare providers. The shift in presidential talking points was only slightly less abrupt than the switch from "global warming" to "climate change."
26 weeks ago
26 weeks ago Link To Comment
Actually you won't even get better coverage as well. all those people with 1500$ copays and $3000 deductibles are, for all intents and purposes, functionally uninsured. It is going to open up a whole black market for health insurance under the table and the economy and peoples health will get worse as a result.
26 weeks ago
26 weeks ago Link To Comment
Unless it get's outlawed, it looks like there might be an oppurtunity for private pay doctors and hospitals. If they price things what they actually cost, and refuse all insurance, they may attract patients who don't have the patience for govt cruft.
26 weeks ago
26 weeks ago Link To Comment
Turntable.com is a private "Membership" based wellness care system here in Las Vegas. It sounds pretty good, but I don't know anyone who has it. I expect there will be more of these "creative solutions" cropping up, unless they are outlawed for being "too creative".
26 weeks ago
26 weeks ago Link To Comment
I have already negotiated a "cash discount" with ALL the Specialists we see, since NONE of them are taking our "O'Drama-scare" HMO.
26 weeks ago
26 weeks ago Link To Comment
Many doctors will give you a discount if you pay cash. There is a website (http://selfpaypatient.com) that well explains your "options" if you are able to pay "cash" instead of having the doctor "bill" your health insurance.
26 weeks ago
26 weeks ago Link To Comment
What is interesting is that Obamacare is making the pop trends in TV shows. Last night, I happened to see that 'Two Broke Girls' had a completely unnecessary Obamacare ER scene. They didn't really go anywhere with it but it was interesting to see the reference. Basically, showing up for treatment, they are asked for insurance, the girl says she wants to use her Obamacare. Everybody has a right to Obamacare. The receptionist just stares. They try "password: Malia". Then the receptionist tells them they need to go figure out their insurance and then come back. Then the whole thing is dropped, next scene.

Given the audience, that scene is probably more information about the realities of Obamacare than most have considered.
26 weeks ago
26 weeks ago Link To Comment
Reverend Michel Faulkner was on with Greta last night and made some very good points about the (un) Affordable Sickness Act and this president.

video

http://gretawire.foxnewsinsider.com/video/video-the-rev-michel-faulkner-on-the-record/

26 weeks ago
26 weeks ago Link To Comment
I begin to understand your problem now Stephen, you value substance over image. Haven't you realized yet, this administration is all about the image, substance is irrelevant. How absolutely primeval of you to want substance.
/sarc
26 weeks ago
26 weeks ago Link To Comment
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