Capitol Hill Daily predicted that the eventual outcome of Obamacare would be a two-tiered medical system – one system for the wealthy, and another system for most Americans.
Obamacare health plans, Medicare and Medicaid recipients will get one level of care akin to what socialized medicine affords in Britain and Canada. Meanwhile, those with private insurance off the exchanges will have a completely different experience.
It seems the new system is already taking shape, considering the revelations that many of America’s best hospitals aren’t letting in the Obamacare masses.
You see, the Obamacare plans are risky for insurance companies. They don’t have good data on who will actually show up and buy plans. It’s assumed by the biggest insurance companies that the clients in the Obamacare pool are likely poorer, with larger medical problems. They assume these are the people that couldn’t get insurance because of preexisting conditions.
To hedge their risks, insurance companies are asking providers to accept smaller reimbursements. Therefore, only the hospitals and doctors that need business are accepting the smaller Obamacare reimbursements. The best hospitals, the ones that don’t need more business, decide to opt out, effectively shutting their doors to Obamacare patients.
A Dim Future
The system is so convoluted and byzantine that you pretty much need a PhD to decipher it. First, the hospitals negotiate with insurance providers. The insurers get reduced pricing from the hospital in exchange for sending in large numbers of clients. These networks of hospitals and doctors are the result of intense negotiations, and they’re usually built out over years.
Now, as a result of Obamacare, things are changing. Most of the firms assume the young and healthy people that are needed to balance the Obamacare budget won’t show up. So they’re asking providers to accept smaller and smaller reimbursements.
But if you’re the Mayo Clinic, the Cleveland Clinic or Cedars Sinai, for instance, you just don’t need to accept smaller reimbursements – or you can’t afford to. So you opt out. This is also how Medicare works, and it’s no coincidence that if you walk in the front door of the Mayo Clinic, you’ll be greeted by a sign that says “We don’t accept Medicare.”
A Watchdog.org study of the top-tiered hospitals found they’re not easily accessible to the Obamacare insurance exchange participants. For example, in Ohio, the Obamacare exchange includes a dozen insurance companies – yet the state’s premier hospital, the Cleveland Clinic, accepts only one of those dozen firms. If you’re buying on the exchange in Ohio, make sure you read the fine print!
Last year, I had a cardiac ablation, and I wanted to go to the best hospital in the country for the procedure. I chose Cedars Sinai in Los Angeles and had an excellent experience. They treat you like you’re taking a trip to the spa. But if you’re buying from the exchange in California, you’ll find that only one insurer is accepted by Cedars.
So if you want the best doctor, stay out of Obamacare. Want the best specialists? Stay out of Obamacare. Want the best hospital? You get the picture. Sadly, this same advice is true for Medicare, which is suffering the same fate. Medicare, which all Americans must participate in by government edict, is facing drastic reimbursement cuts to provide money for Obamacare.
Of course, the changes won’t all come in a day or even a year. But Medicare Advantage Plans – which are highly rated by the seniors that participate in them (such as my Mom and Dad) – are targeted for extinction by Obamacare. It’s proving the old adage that you can’t have something for nothing.
Foolish people believe that the siren song of socialism will pay in the end. But if you want the best medical system in the world, it costs money. If our country doesn’t want to pay for it, then it will morph and change until we have a sub-class healthcare system. And in the end, the wealthy will get great care even if they have to leave our shores or hire concierge doctors. It’s sad that Obama’s socialism is sacrificing a once-great system on the altar of false equality.
Your eyes on the Hill. Floyd G. Brown
This commentary first appeared at CapitalHillDaily.com and is republished here with permission.
Photo: Credit: Standard Compliant