Looking beyond the premium is a 2-tiered health system? | Deseret News National
Get Deseret News National Email Updates Every Day.
Shutterstock
Causes

Looking beyond the premium is a 2-tiered health system?

The New York Times reported on Monday that consumers signing up for Obamacare on the federal or state exchanges are now facing deductibles that make the "affordability" of the premium a dubious bargain.

"In El Paso, Texas, for example," the Times reported, "for a husband and wife both age 35, one of the cheapest plans on the federal exchange, offered by Blue Cross and Blue Shield, has a premium less than $300 a month, but the annual deductible is more than $12,000. For a 45-year-old couple seeking insurance on the federal exchange in Saginaw, Mich., a policy with a premium of $515 a month has a deductible of $10,000."

With consumers and politicians focused on premiums, high deductibles are only now sinking in. "Higher deductibles are one tool that insurers can use to hold down premiums," The Times reports, "Many have also held down premiums on the exchanges by limiting the choices of doctors and hospitals available to consumers in their provider networks."

Limits on choices in doctors and hospitals have been on the radar screen for several months.

The Washington Post recently reported that Seattle's Children's Hospital has been dropped from insurance by the state's predominant insurer. “Children’s non-unique services were too expensive given the goal of providing affordable coverage for consumers,” Premera Blue Cross spokesman Eric Earl­ing told the Washington Post in an email.

A spokesman for Seattle Children's Hospital told the Post that "his hospital often bills more than community hospitals for comparable procedures because the children it treats are often gravely ill, so even a routine tonsilectomy may be more complicated."

The Washington Examiner interviewed insurance agents and medical professionals around the country and arrived at a disturbing picture of shrinking availability.

An agent in Sacramento told the Examiner, "Roughly a third of the doctors are going to be accepted in the networks. I’m finding very few specialists in either the Anthem or Blue Shield networks.” Another in Las Vegas said that the “lion’s share” of doctors are avoiding the exchanges.

The article also quotes a Virginia agent who said "there is a lot of disruption" in Lynchburg, home of Virginia Technical Institute. "They have no providers in that area," she said, "They have to drive an hour to see a physician.” None of Lynchburg's three hospitals are available to exchange patients, the Examiner reported.

Jim Powell at Forbes describes a "tumultuous" town hall meeting in Connecticut after a major carrier announced it was dropping 2,250 doctors in the state, or about 19 percent of the total previously available.

"This was the occasion for a tumultuous town hall meeting in affluent Westport where a parade of Democratic politicians — headed by Connecticut’s senior U.S. Senator Richard Blumenthal — piled on the insurance company, calling it arrogant, greedy and unconscionable," Powell wrote.

Email: eschulzke@desnews.com