Oh, I know my lib friends will tell me that all of this is either the result of the still eeeeevvvvviiiiilllll insurance companies and of course the fact that this is such a large program, this Obamacare.
Well today I will share two aspects of the so-called Affordable Care Act. One is this article from the Left Angeles Times and the other a personal true story.
The thrust of the Times article is that, surprise!, many of those enrolled the California state health insurance exchange, Covered California, are having trouble with doctors and whether or not they are actually a part of Covered California.
Take Danielle Nelson of Aliso Viejo in Orange County, California.
Miss Nelson signed up with Anthem/Blue Cross HMO and at the time of her sign-up already been diagnosed with non-Hodgkin's lymphoma. In January she discovered a lump near her jaw. When she signed up under Covered California Anthem/Blue Cross, she was assured multiple times that oncologists that she wanted were part of the network they work with. But she went to her oncologists office and, again surprise!, there is a nice bright orange sign saying that in fact they are NOT part of Covered California Anthem/Blue Cross. The sad part is Miss Nelson's reaction to this:
"I'm a complete fan of the Affordable Care Act, but now I can't sleep at night. I can't imagine this is how President Obama wanted it to happen."
Yes, I am doing a major-league face-palm and a couple of SMHs*.
It does not matter what the Dear Leader, President Obama, wanted to happen. What is reality is because, in the immortal words of then Speaker of the House, Rep. Nancy Pelosi (D-Ca.), we have to pass the bill to see what's in it.
And of course this is what is in it.
Because the crony capitalist health care companies need to hold down costs, they are offering fewer doctors and hospitals that are in network.
Thus insurance companies are putting incomplete and uncorroborated information about doctor and hospital availability. And it is affecting real people. People like Miss Nelson.
But get a pant load of this from the California insurance commissioner, Democrat Dave Jones:
"It's a little early for anyone to know how widespread and deep this problem is. There are a lot of economic incentives for health insurers to narrow their networks, but if they go too far, people won't have access to care. Network adequacy will be a big issue in 2014."
The now head-shaking face-palms and SMHs are getting stronger.
It is proof of what we who opposed the so-called Affordable Care Act warned long before now. It is one of the reasons that some people like Sen. Ted Cruz (R-Texas) and Sen. Mike Lee (R-Utah) wanted the whole hot mess repealed.
I highlighted the second part of Mr. Jones' comment because there is cost-containment right at the point of doctor and hospital availability. And Mr. Jones' is correct that hell yeah, this is a huge issue. And it is not limited to California.
In defense of the people that did sign-up in the health insurance marketplace, they went by information provided by the insurance companies and Covered California. The least that it can be is accurate, up-to-date information. Especially because many of those signing up are people with serious, preexisting conditions.
Again, we warned of these things happening not by error but by design. Because one can not expand a pool of people, many unhealthy to begin with, and expect Cadillac health care. Hell for many that do not get the federal subsidy, its not really all that affordable.
Now I would like to relate a direct effect of Obamacare on my household.
For about eight years now, we have been getting health coverage thru Mrs. RVFTLC's employer. It is an HMO and by and large we have not had any problem with it. Sometimes the referral process is a bit long, but otherwise it is great coverage for us.
Mrs. RVFTLC is diabetic and uses an insulin pump. The pump itself is constant, but the supplies that go with it to make it work are not and have to be ordered like a prescription. There is a needle attachment and the reservoir that goes in the pump for the insulin to be in. The insulin is essentially constantly pumping the insulin through a narrow tube and is part of the needle attachment.
There is some background.
Mrs. RVFTLC had been waiting for the replacement supplies since the beginning of the year. She contacted the pump company, Medtronic, and they had placed the order for the replacement supplies. Again, this was the first of the year. She was waiting. And waiting. And realized that she was running out. Without the supplies, she has to go back to shots which has it's own problems. Once again she contacted Medtronic and was told that they are waiting for authorization from the insurance company. She was told by Medtronic and her regular diabetic doctor/internist that this is due to all the enrollment into O-care. That the insurance companies are backed up in such authorizations. Now as I noted, Mrs. RVFTLC can use shots. But the interruption means that she has to essentially reset the pump, which is a long process and often requires phone assistance from one of Medronics very wonderful staff. If you are having to use an insulin pump, this company is awesome and I would recommend that you should get your pump through this company. We are not under any O-care plan. This is health insurance provided by Mrs. RVFTLC's employer. Yet because of all the changes wrought by O-care, Mrs. RVFTLC is a victim. It makes me wonder how many other diabetics are in a similar situation not just in California but in the United States?
These examples are but many highlighting the folly that has been and is health care now in the United States. The standards of those that already have insurance, whether it is a group policy provided by an employer at shared cost or on the open individual insurance market is clearly being lowered. At some point I will not be surprised if the insurance company will stop authorizing insulin pumps due to costs. What this health care scam does, as all government controlled plans do, is stifle any innovation. Better drugs? More expensive. New treatments? Too expensive. To keep everyone covered, costs are paramount, not patient care. And while the eeeeevvvvviiiiilllll health insurance companies have done that on more than one occasion, do you still really think that government controlled health care will do better? Of course not. It never does.
When this so-called reform truly affects real people and their health problems, the folly of it makes it all the more tragic and must lead to repeal the so-called Affordable Care Act and replace with real reform that will truly give those with no access to health care insurance coverage just that and not lower the plans that the vast majority of Americans have now.
*SMH-Slap My Head
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