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The PJ Tatler

by
Bryan Preston

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January 31, 2014 - 11:35 am

Obamacare’s official name is the Patient Protection and Affordable Care Act. Other than protecting actual patients and making healthcare affordable, it’s doing a bang-up job.

Take the Seattle Children’s Hospital, for instance. Its administrators tell KING-TV that thanks to Obamacare, many of the sick kids in its facilities can not get the care that they need. The hospital sought approval to care for more than 100 kids under Obamacare, and got silence and a handful of denials in return.

Dr. Sandy Melzer from Seattle Children’s Hospital: “Well, some of the patients who were denied are ones who would clearly fall into that unique category [of needing specialty care]: a two year old with a new, significant neck mass that was being evaluated for infection or malignancy, an older child with a chronic, severe medical condition requiring multidisciplinary care here, a baby that had a skull abnormality.”

In all, the hospital says it has applied to the government for care for 125 children. Only 20 have gotten replies, and 8 of those were denials.

So, 12 of the 125 kids who need care — less than 10% — actually got approval.

The hospital went ahead and cared for all of them, picking up the tab — which it can’t afford to keep doing without reimbursement. Obamacare turns out to be an excellent way to bankrupt hospitals, chase doctors out of practice, and wreak havoc in the personal lives of millions of Americans.

Republicans could be building their 2014 campaign around this and stories like it. Instead, they’ll take a little of this plus a destructive battle over immigration that hardly anyone wants to have.

Because they’re idiots.

Bryan Preston has been a leading conservative blogger and opinionator since founding his first blog in 2001. Bryan is a military veteran, worked for NASA, was a founding blogger and producer at Hot Air, was producer of the Laura Ingraham Show and, most recently before joining PJM, was Communications Director of the Republican Party of Texas.

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Top Rated Comments   
Ezekiel Emanuel---Rahm Emanuel's brother, and one of the architects of Obamacare---has argued for rationing medical care on principles that give anyone under 10 very low priority. This should have been a major issue when Obamacare was under discussion. See the chart on page 428 of http://bme.ccny.cuny.edu/faculty/mbikson/Courses/BMESeniorDesign/EthicsOfHealthRationing.pdf.
34 weeks ago
34 weeks ago Link To Comment
Just a taste of things to come......
34 weeks ago
34 weeks ago Link To Comment
All Comments   (15)
All Comments   (15)
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The only way to bring down the cost of healtcrare is through rationing, denying care & holding down innovation. It's cheaper to pay for an abortion than cover childbirth. The chronically ill will be the first to have their care curtailed, especially if they are young & can't contribute via taxes or the elderly for the same reason. It will be like demographics for a tv show the coveted 18- 55. Anyone on either side forget about it.
And there is a little provision in the law that if a drug or procedure is not covered and you are willing to pay for it on your own, you will go to jail
34 weeks ago
34 weeks ago Link To Comment
and still the liberals refuse to accept the facts as they keep getting reported and violently attacking the messengers of the truth to their delusions
34 weeks ago
34 weeks ago Link To Comment
So let me get this straight.

1. The requests are from the hospital to insurance companies not government denials.
2. Seattle Childrens hospitals was dropped from exchange plans provided by insurance companies because they were out of line sometimes costing nearly double the price of other hospitals for similar procedures.

I'm not sure where the outrage is. No one made a fuss when my employer went to an HMO and dropped my doctor.

It's like anything else in life. If you want the best you need to pay. Burger flippers on exchange plans aren't going to go to a luxury hospital.
34 weeks ago
34 weeks ago Link To Comment
There is a high likelihood that most of these kids were on CHIP coverage which is a government paid insurance plan.

Your HMO did allow for out of network referrals/coverage for specialized care - that's no longer an option.

Seattle Children's provides highly specialized care not available elsewhere.

The parents did not have a choice in the loss of coverage - it was stripped from them by law.
34 weeks ago
34 weeks ago Link To Comment
According to the hospital's press release this is about insurance policies provided on the exchanges. The hospital requested the insurance company - not the government - provide out of network coverage for specialized care.

Seattle Children's Hospital had previously filed suit alleging that the exchange insurers aren't providing adequate coverage in their networks because they don't include Children's Hospital.

As for "stripped by law", Seattle Children's is an expensive hospital. If parents want a policy that includes Seattle Children's hospital they are free to choose a policy that covers treatment there but - it might cost more.

I don't see anything wrong with that as I pay extra for a policy that reimburses me for out of network care.
34 weeks ago
34 weeks ago Link To Comment
But they were told they would...
34 weeks ago
34 weeks ago Link To Comment
Your average burger flipper for say McDonald's has a mini-med plan with caps as low as 10k per year.

If Seattle Children's Hospital is a provider, maybe you could go to the expensive hospital but 10k is practically gone before the ink dries on the admissions form.
34 weeks ago
34 weeks ago Link To Comment
Ezekiel Emanuel---Rahm Emanuel's brother, and one of the architects of Obamacare---has argued for rationing medical care on principles that give anyone under 10 very low priority. This should have been a major issue when Obamacare was under discussion. See the chart on page 428 of http://bme.ccny.cuny.edu/faculty/mbikson/Courses/BMESeniorDesign/EthicsOfHealthRationing.pdf.
34 weeks ago
34 weeks ago Link To Comment
I read that entire article on medical "ethics" around the time it came out. Chilling is putting it mildly. Pointing out to family members that they wouldn't have received their replacement hips if this had been in effect didn't stop them voting for Ø, heaven help us. "Oh, but the gov't would never actually do that!". And these are people with post graduate degrees.....
34 weeks ago
34 weeks ago Link To Comment
Mr Preston,

What were the turn around times on the 20 replies to date?

Also how long ago have the other 105 requests been submitted?

What was the turnaround times for insurance companies?
34 weeks ago
34 weeks ago Link To Comment
Last word from ABCNBCCBSMSNBCTASSNKNANSDAP on this story:

Crickets.
34 weeks ago
34 weeks ago Link To Comment
oh but the campaign ads write themselves!
34 weeks ago
34 weeks ago Link To Comment
Just a taste of things to come......
34 weeks ago
34 weeks ago Link To Comment
Holy Toledo, Brian. This is a major story.
34 weeks ago
34 weeks ago Link To Comment
Sorry. Should be Bryan.
34 weeks ago
34 weeks ago Link To Comment
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