Thursday, December 05, 2013

The next problem for Obamacare

So, you need to see a specialist? Well, maybe you can't. The invaluable Walter Russell Mead explains:
The discrepancy between policy and the problems it is supposed to address has never been clearer than in the health care debate. The Seattle Times reports on the network restrictions that are increasingly limiting Washingtonians’ ability to see key doctors and hospitals without incurring major financial risk. The plans offered in the Affordable Care Act exchanges, it turns out, keep premiums low by drastically reducing the number of providers covered. 
My personal brush with the health care system happened nearly seven years ago, when I was diagnosed with a pituitary tumor and had surgery to remove it. I wrote about the process at the time it happened; it was an amazing thing to watch the system leap into action. From the moment of diagnosis to the end of the first day, I was able to see the clinic doctor, a neurosurgeon, a neurologist, an otolarynlogist and an endocrinologist. The next day, I would see an ophthalmologist as well. That's five specialists. The endocrinologist remains my principal doctor to this day. In a drastically reduced network, I might have had access to these people, but chances are good it would have wiped us out financially.

There's a lesson in this -- keeping the costs down might be important, but it's going to have implications that we aren't yet prepared to handle. And as always, I must caution those who are gung-ho for single payer to consider the obvious question: what is your recourse if the single payer doesn't pay?


W.B. Picklesworth said...

"[W]hat is your recourse if the single payer doesn't pay?"

What does history teach the answer will be? Blame the single woman (the witch.) Blame the religious minority (the Jew.) Blame the landowner (the Kulak.) So who gets to be bogeyman this time? They've been blaming conservatives (haters), whites (racists), and the cautious (deniers). But will blaming majorities or large minorities work? Doesn't the whole blame strategy work better when the target is too small to defend themselves?

Anonymous said...

The only problem with the statement that limiting networks will keep the cost low is that the costs are not low with Obama Care. In fact, as things move forward, I think you will see that costs have doubled. Worse coverage for more money, what a deal!