

New Affordable Care US health plans will exclude top hospitals - yapcguy
http://www.ft.com/cms/s/0/994951f8-5e71-11e3-8621-00144feabdc0.html

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treerex
Is this really an issue that surprises anyone? If you are paying for a lower
tier of insurance then it makes sense to limit the hospital choices available
to you. The whole "I'm going to pay less but still want the same level of care
as someone paying a premium" attitude needs to go.

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001sky
_The whole "I'm going to pay less ..._

That's the fallacy right there. Nobody is paying 'less'. The system is
absorbing new risk, so service is being cut. I'm not so sure why that's hard
to understand. Read the article, and its quite clear the reportage is about
incremental exclusions, required to offset "new costs"...

 _When the Obama administration was asked whether the new healthcare exchanges
were offering adequate network options to new consumers, a spokeswoman for the
Department of Health and Human Services (HHS) emphasised that the new
exchanges would “vastly increase” the access to medical providers to millions
of uninsured Americans._

So, part of the deal is belt-tightening.

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HelloMcFly
The one area where I wonder about this is Children's hospitals. There's been
some stories in Seattle because most of the Washington Health Exchange plans
excluded Seattle Children's, which may be a problem for families given that
Seattle Children's provides services that other hospitals in the area can't
and/or don't.

At least one insurance company in the area has responded by electing to cover
unique services provided by Seattle Children's, so that's at least a middle
ground.

------
rayiner
"Could I just subscribe to the internet so I never hit a paywall?" \- Mrs.
'Rayiner.

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karzeem
A book called Catastrophic Care came out recently. It's written by a guy named
David Goldhill, who wrote a cover story for The Atlantic in 2009 on broken
incentives in the healthcare industry that tend over time to push prices up
and quality down. (His unrelated day job is CEO of the Game Show Network.)

The book gets at the problems in the industry on a much deeper level than
anything else I've seen.

For a good summary, check out Goldhill's Big Think interview on the subject:
[http://bigthink.com/ideas/big-think-interview-with-david-
gol...](http://bigthink.com/ideas/big-think-interview-with-david-goldhill)

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cgearhart
It's hard to read and comment on an article behind a paywall...

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JacobJans
It's not a paywall. They let you read 8 articles a month, without giving them
any money to support their operations.

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rschmitty
I've never been to FT.com and I instantly got a paywall. Are there sister
sites that would count against their monthly limit?

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JacobJans
It's not a paywall. Enter your email address and select the free option. They
make you jump through hoops, but you don't have to pay.

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clubhi
I'd rather pay than fill out a form.

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btian
Well you'll have to fill out a form before paying, so the choices are really
fill out a form + pay vs. fill out a form

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yapcguy
If you hit a paywall:

[http://pastebin.com/3badDzhY](http://pastebin.com/3badDzhY)

 _> "Americans who are buying insurance plans over online exchanges, under
what is known as Obamacare, will have limited access to some of the nation’s
leading hospitals, including two world-renowned cancer centres."

"Amid a drive by insurers to limit costs, the majority of insurance plans
being sold on the new healthcare exchanges in New York, Texas, and California,
for example, will not offer patients’ access to Memorial Sloan Kettering in
Manhattan or MD Anderson Cancer Center in Houston, two top cancer centres, or
Cedars-Sinai in Los Angeles, one of the top research and teaching hospitals in
the country."

"Experts say the move by insurers to limit consumers’ choices and steer them
away from hospitals that are considered too expensive, or even “inefficient”,
reflects the new competitive landscape in the insurance industry since the
passage of the Affordable Care Act, Barack Obama’s 2010 healthcare law."_

Isn't this the same as existing insurance plans where you have a certain
network of doctors or hospitals you have access to, and if you access services
out of network, you have to pay?

I guess there is some controversy if insurance companies drop your plan which
provides coverage to top hospitals, and you can't find a similar plan on the
new exchanges to replace it, and if one does exist you have to pay an arm and
a leg for it.

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Volundr
There is the unspoken assumption here, with no evidence to back it up, that
the majority of plans _not_ offered on the exchanges _before_ the ACA would
cover these hospitals. Unless that was the case, then this is a non-story, as
nothing has really changed. Personally I suspect most of the pre-ACA plans
considered these out-of-network as well.

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lettergram
I hear there are three or four doctors on Google Helpouts for free...

