Getting Even Narrower

Hospital-Bill-Total

Please get the word out.  The networks of doctors and hospitals you are allowed to go to are getting smaller and smaller.  This from a recent Washington Post article:

But as more health plans limit the physicians and hospitals in these networks (to keep premium costs low), consumers are increasingly getting hit with surprise bills from out-of-network providers.

Hospitals often contract with experts, such as anesthesiologists, emergency physicians, radiologists and even assistant surgeons. But many times, those doctors don’t participate in the same plan networks as the hospital, so they’re considered out-of-network.

And that the beauty of this broken system is that no one has to tell you whether the doctor is a participant in the plan!  I guess you, in your medical stupor, are supposed to ask?

Want more?

An analysis released in July by consulting firm Avalere Health found that consumers who bought insurance on the health exchanges last year had access to one-third fewer doctors and hospitals, on average, than people with traditional employer-provided coverage.

Let me end this travesty with these quotes from President Obama:

July 21, 2009: “If you like your current plan, you will be able to keep it. Let me repeat that: If you like your plan, you’ll be able to keep it.”

Aug. 20, 2009: “No matter what you’ve heard, if you like your doctor, you can keep your doctor under the reform proposals that we’ve put forward.”

He said the above statements 37 times in public forums.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Getting Even Narrower

  1. Brandon T
    September 9, 2015 at 10:02 am

    I’m a medical student in a PhD program and have kids. President Obama’s comments couldn’t be less true for me at my public university medical school. When I joined my program they offered a 100% dependent coverage subsidy, which was a selling point for this university. What’s happened in the mean time is unbelievable. That subsidy turned into 80% two years ago. It was a bear fight just to maintain the status quo this year. The trade off this past year they did some big cost shifting in the plan to decrease the fees for single students (-$250/year) and increase the rates for our plan (+$5,000). The single 26-year olds without any health problems have all left the group plan anyway.

    But what will shock people is that this is the last year our university will offer dependent coverage whatsoever. They’re washing their hands of us. And the following year will be the last the the University provides health insurance options to professional students in any capacity. I met with the dean about this and she says everyone in the country is going this way, so they don’t really have any choice. So, Obama was wrong–we can’t keep our plans at a public university.

    • Perry
      September 9, 2015 at 1:18 pm

      Brandon,

      I do feel for you, we see it every day. My question is, how many people in your university admit to voting for Obama? Just wondering…

  2. Benjamin Van Raalte
    September 8, 2015 at 1:38 pm

    And that is why the anesthesiologist radiologist and emergency room doctors probably make the most money for the least hours work.

    It says if you built the house and hired a contractor. Then the contractor hired subcontractors. You agreed on a price with the contractor. Then after the house was built all the subcontractors presented you with additional bills. The contract is worthless.

    That’s exactly the problem with anesthesia, radiology, and emergency medicine. They get exclusive contracts with the hospital. That prevents competition and raises prices. Then they refuse to sign contracts with the plans the hospital is in. Over time that leads to pay increases for those specialties. As long as they don’t create a oversupply in their field they are in great shape.

    The only solution is that any physician who is contracted with the hospital and the patient doesn’t have the right to choose should automatically be part of any plan the hospital contracts. The other choice is the limit balance billing to know more than 150% of Medicare.

  3. Perry
    September 8, 2015 at 10:32 am

    But isn’t it great how many people now have insurance????!!!!
    (major sarcasm)

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