More Narrow Network BS

Remember when President Obama said if you like your insurance plan or doctor, you can keep your plan and your doctor? I think he said it 36 times.  Well, we physicians knew that was all a scam.  And guess what?  We were right.  Now NPR gets in on the act years later and speaks about this travesty but they do it in a laughable manner.  The person they interview is Julie Rovner (from Kaiser Health News) who says this:

“Well, this is something that dates back to the beginning of the Affordable Care Act. Remember, they’re required – insurers are required now to provide this wide array of benefits. And when they were starting to put together their plans, they thought, how are we going to do this and still keep this insurance affordable? And one of the ways they did that was by having what we call narrow networks, meaning they only contract with a limited number of doctors and hospitals. And the hospitals that they most often don’t contract with are these big teaching hospitals because they tend to be expensive.

So we’ve seen this not just in places like Virginia, but we’ve seen it across the country starting in 2014 when this began, where people who had children or family members or themselves in the middle of – often, cancer treatment – were suddenly cut off from their hospitals. So it is a big problem for people who have ongoing care needs like this family. This year, when there are so many insurers that have pulled out of the market – because as you discussed, of the instability and the things that the president has done – there are more people who only have a choice of one insurer. So that if that insured doesn’t cover the hospital that they need, they have a problem like the Briggs.”

So, let’s break this down. The narrative they are trying to spin is that the insurers HAD to do this. You know, to save money and keep insurance affordable. Affordable? That must be a joke.  Rovner then implies that cutting back on doctors by narrow networking was smart business that was expected out of the insurers.  Really?  So, this proves Obama lied right off the bat and this wasn’t a surprise when it happened. Funny thing, you don’t hear that talked about much in the media.  In the next paragraph, Rover then puts the blame on this president.  What?  Love or hate him there is nothing he really did that caused this mess.  This piece of crap legislation was a massive tax that only benefitted the few and filled the coffers of the insurance companies. It was and still is an embarrassment.  Saying anything else is just a rationalization.

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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] 

  7 comments for “More Narrow Network BS

  1. November 30, 2017 at 9:14 am

    Congress is trying it’s best to preserve the status quo no matter what technological, political, and social pressures they face to modernize. They are standing for centralized, opaque command and control health care system when it has been shown to be increasingly a failure. They are now Gorbachev in 1988 right before the end of the USSR. Times have changed and they will only change when forced to do by popular will, which is happening all around them.

  2. Martha Clark
    November 30, 2017 at 8:51 am

    Sorry using this post to vent, please feel free to remove. Just found your blog searching for articles on chronic pain. Enjoyed your take on it and made me rethink my views on the subject.

    I’m an RN in TX. My experience with ACA has been horrible at best.

    Last year I lost my health insurance coverage as my employers (physicians) couldn’t afford it. Foolishly I signed up for an ACA plan. Basically paid $400.00/mth for ‘insurance’ I couldn’t use. An example of my wonderful experiences: when I called to complain about a lack of in-network specialists (specifically GI) I was told by a representative to ‘call around’ to try and ‘make a deal’. Umm…I thought I was paying YOU to do that!

    The so-called ‘insurance’ sent my daily reminders to fill out health questionnaires with offers of VISA cards and other ‘freebies’ if I did. Not really a ‘freebie’ if my tax dollars are paying for the subsidies required to make these offers. I don’t need your VISA cards, I NEED a doctor who can treat my illness!

    Luckily I’m now on my boyfriend’s insurance, but even then, the deductible is so high, I can’t use it. We DO have an HSA component though, so not ALL bad.

    Due to the many requirements demanded by ACA making overhead costs skyrocket, the two physicians I worked for (pediatricians) were basically forced to retire. They closed their office in August. Patients and employees are still grieving over this loss.

    I foolishly supported ACA prior to implementation. Now I’m using my vote, and my pocketbook, as a tool to get rid of this failed experiment. I feel like it’s all I’ve got!

    • RSW
      November 30, 2017 at 11:03 am

      “Due to the many requirements demanded by ACA making overhead costs skyrocket”

      Don’t want to present myself as a defender of the ACA, but what exactly are those demands (serious question)? I’m in a two doc practice and the ACA in and of itself has had zero/zip/nada effect on our practice. There’s a lot of terrible stuff coming out of Washington but it’s not all in the ACA.

  3. RSW
    November 29, 2017 at 8:18 am

    Increasingly narrow networks have been a fact of life for the last twenty years. They’re frequently a collusion between an insurer and a large hospital corporation/academic center, in an effort to keep prices up and send the bill along with a handling fee to self-insured employers.

    It doesn’t make doctors look smart to blame everything they don’t like about the current medical environment on the ACA.

    It’s raining here this morning – damn that Obama!

  4. Pat
    November 29, 2017 at 7:29 am

    “Journalists”, LOL…

    And now my customary challenge: I railed on this site years ago that the ACA was a lie, a deception, theft, and a guaranteed disaster. Some argued with me here that we “had to do something”, and called this a good try, and compassionate. Asking government to be more involved with health care is always a dumb move – where are the ACA supporters now? Still hiding?

    • Steve O'
      November 29, 2017 at 8:18 am

      They’re probably working behind the scenes at the most revolutionary transformation yet. Medicine is destined to be a high-tech low-salary service industry, which works at the call center on Black Friday, but not when your kid is sick. I call it McMedicine.
      It is indisputable that this is the aim, not only for medicine but everything. In the slamthrough of this “critical tax bill” in Congress, the veneer that they peddle this atrocity is helping “small business.” But the language is that of international corporations and tax accrual and writeoffs at a multi billion dollar scale.
      We are brainwashed to think that “business” always means a massive, hierarchical corporate/governmental style model, and boy does CMS/Medicare/Insurers fit the bill! Physician drones will push the paper, and the corporation will write off the taxes.
      In the same way that the local physician’s office became McDocCo Urgent Care, so too the GENUINE small business of America in towns and small cities. Thanks to big corporate power, the tax and revenue structure favors big corporate power over small business. If you don’t buy the dogma that this is mandated by The Invisible Hand, you must be a Michael Moore leftist.
      Let’s have more writeoffs for the holding companies that ship and shop doctors, nurses and clinics, with CMS approval of course – and see how much more of the same we get!

    • Perry
      November 29, 2017 at 9:37 am

      No, they are still trying to defend it, as evidenced in the above article.

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