Who Didn't See This Coming? Second-Class Healthcare In A Third-Class Way Under Obamacare
If you like your doctor...you could lose your doctor. I'm guessing other healthcare plans will soon follow Highmark's lead.
Highmark said Friday it plans to reduce what it pays doctors who treat patients with Obamacare plans.
Wes Venteicher writes at TribLive:
Citing an estimated $500 million loss last year on health insurance plans sold on the Affordable Care Act marketplace, Highmark Inc. said Friday it plans to reduce what it pays doctors who treat patients with the plans.Highmark plans to reduce payments to the physicians by 4.5 percent starting April 1 as part of a broad effort to stem losses related to the federal marketplace, said Alexis Miller, Highmark's special vice president of individual and small group markets.
Miller estimated the insurer paid about $500 million more for patients' care in 2015 than it collected in premiums for the plans sold on the federal marketplace, resulting in the loss. Highmark officials have said the people who signed up through the health law's marketplace were sicker than the insurer expected.
John Krah, executive director of the Allegheny County Medical Society, said doctors should not be held responsible for Highmark setting plan costs too low to cover patients' care.
"It's inappropriate for Highmark to seek to compensate for their failure to price these products appropriately by paying physicians less," Krah said.
Faced with lower reimbursement rates for ACA patients, doctors could end up setting quotas for how many of the patients they would accept at their practices, the way they do for Medicare and Medicaid patients, he said.
By then, Obama will be out on a golf course somewhere, leaving his trail of "Affordable" "Care" turds for the next president.
And do note how I wrote that above. It used to just be "Affordable" in scare quotes. Soon, it'll be joined by "Care."








You mean the math doesn't work? I'm shocked! Shocked, I tell you! Who could have imagined this outcome?
I'm sure it's purely a coincidence that the current Democratic party front-runner for President is running on a platform that explicitly includes government-operated single-payer healthcare -
Which Was The Plan All Along.
I heard one of his proxies on NPR this morning telling us that it is way past time that the for-profit insurance companies were broomed out of the healthcare system, that their profits and business expenses simply steal money from people's health care, and that single-payer systems in other countries show that this is the best, fairest and most-logical way to fund healthcare. She even gave the promise that single-payer will reduce healthcare costs, just like Obamacare was promised to do.
So the private health insurers who were key partners in Obamacare, just 5 years ago, are now evil profiteers who can't be removed from the healthcare system fast enough. I wonder whether those insurance companies who so eagerly signed on to Obamacare with promises of vast new markets and bottomless pits of government subsidies regret their enthusiasm to board the ship that is now being deliberately scuttled. They obviously forgot one of the rules of Alinskyite progressive politics - you have to get them into bed, before you can f*ck 'em. (Pardon my language, but no other words express the principle so well).
This is the exact-same approach that was used to create single-payer healthcare in the UK in the late 1940s - the architect of the UK NHS, Aneurin Bevin, famously described how he bought off the private health-care operators to get single-payer forced through by 'stuff(ing) their mouths with gold'.
National Health Service, here we come. Google things like 'Mid Staffs' and 'Liverpool Care Pathway' to see what the future holds. Private health insurance only costs you money - government-operated single-payer healthcare all-too-often costs you your health, or your life.
llater,
llamas
llamas at February 23, 2016 4:56 AM
Who needs "death squads" when the 'national' rescue squad can accomplish the same thing:
UK System At Work In 2016
1) A diabetic student nurse who had a heart attack after waiting almost five hours for an ambulance when she called 111 could have survived if she had arrived at hospital sooner, an inquest has heard.
Lisa Day, 27, a Type 1 diabetic, had been staying at a friend's house when she fell and started vomiting blood, prompting the friend to call 111.
But, despite Ms Day being given a 30-minute response time, the ambulance did not turn up for five hours because there were not enough available.
2) A dying elderly man wrote a heartbreaking goodbye note to his family after waiting almost two hours for an ambulance to attend to him.
Roland Volante, 74, suffered heart failure in his flat in Wirral on Bonfire Night, an inquest heard.
Despite pulling the emergency cord, it took one hour forty minutes for paramedics to arrive.
Mr Volante used his last moments to pen a final message to his family before he passed away, which read ‘I love you Rita, I love you Deb, dad’.
Bob in Texas at February 23, 2016 6:20 AM
Don't miss the "30 minute" wait time above as the quoted response time. 30 MINUTES in a non-rural environment. Goody!
Bob in Texas at February 23, 2016 6:22 AM
Hey, Bob, at least she was given a response time - it could have been like the VA suicide helpline and gone to voice mail!?
(yea, I'm getting cynical.)
charles at February 23, 2016 6:34 AM
@ Bob:
The ambulance wait times are the result of a NHS initiative to reduce ER waiting times. It had been determined that the times between arrival and triage were too long. The NHS's budget didn't have enough in it to permit hiring more Doctors and Nurses to see more people as they arrived, and, even if patients were seen faster, there weren't enough beds for those who needed to be admitted. So, one of the solutions is that ambulances stop a few blocks from the hospital. The paramedics provide the treatment they can till the call is received from the ER to bring the patient in as there is now room in the ER. There are instances of the wait in the ambulance being 5 hours. The number of ambulances and EMS crews haven't been significantly increased. However, the program was deemed a success because ER wait times were reduced.
Wfjag at February 23, 2016 6:47 AM
However, the program was deemed a success because ER wait times were reduced.
I imagine that the administrator who came up with the idea got a fat bonus cheque?
This is the VA system, writ large.
I R A Darth Aggie at February 23, 2016 7:40 AM
This is government-run systems writ large.
I read a book a few years back about the Soviet economy. In it, the author, a Soviet emigre, described how the system worked.
Railroads were divided into districts with assigned a number of engines and cars. When a train was about to cross into another district, the engineer was required to dismount the locomotive borrowed from the current district and couple one from the new district, lest the new district fail to return the functioning locomotive on the return trip in order to steal it to replace one of their obsolete ones. This slowed Soviet rail traffic.
In another example, the author cited a factory that was assigned an impossible-to-meet annual quota. In order to avoid total failure and imprisonment, the factory manager divided the quota into 11 easily-met monthly quotas and 1 never-gonna-happen monthly quota. His factory regularly received 11 bonus awards and 1 reprimand every year. None of the higher ups caught on or commented on what he had done. They were getting 11 bonus awards every year, too.
And, to further illustrate how state control and socialism works so much better than capitalism, Venezuela is out of food.
http://www.activistpost.com/2016/02/venezuela-is-out-of-food-heres-what-an-economic-collapse-really-looks-like.html
Growing your own food in Venezuela is tightly regulated. So is hoarding.
Tell me again why we have people who want to vote in socialism and state control.
Conan the Grammrian at February 23, 2016 9:21 AM
I have a policy with a major company. BC/BS through my husbands employer.
Policy costs over a thousand a month. As of this year, it is effectively a catastrophic policy.
The yearly cap on out of pocket jumped from six thousand to ten.
Pays eighty percent of prescriptions (we don't take any) and has a 25 dollar co pay for a doctors visit, and a 350 deductible on everything else that must be met before they pay a dime of anything else.
Think I am going to drop the standard option, in favor of the low one, next open season.
Isab at February 23, 2016 10:07 AM
We paid just under $20,000 for our health care last year between premiums, copays, and cost shares. The actual billed amounts of care we used were we to pay full costs out of pocket were around $9000.
BunnyGirl at February 23, 2016 11:13 AM
I just got an advert from a foot surgeon offering cash only prices and discounts. I don't know how truly odd that is, but it is the first time I've seen one.
We are no insurance this year. You can't get a PPO plan on the individual market any more. Only HMOs available. And my experience with individual market HMOs is they take your money but there are no doctors who will actually see you. The penalty is less than the premium costs plus I get a wider range of doctors to pick from and the from doctor medical costs are less as well.
Ben at February 23, 2016 2:01 PM
Hey, you guys, quit pretending you're having a tough time with your medical insurance. We have a commenter on here whose health care plan is "not going anywhere", thank you very much. I'm pretty sure he voted for Mr. Obama, too, but that's a symptom, not a cause.
Meanwhile...
Radwaste at February 23, 2016 2:39 PM
I'm shopping for insurance and my jaw is on the floor. I'm moving from one company to another, pretty much being forced into the move. Lower pay, but better than if I went somewhere else, so I gotta go. But the insurance offered by new company is no better than on the obama exchange, and I don't qualify for the subsidies. With my old company I pay $150 every 2 weeks for PPO insurance with reasonable copays. With new company they don't offer a copay PPO at all. Their offering is with a PPO at $568 every 2 weeks or $350 every 2 weeks for a high deductible policy eligible for HSA. I had no idea it has come to this. I can't afford it on one income and 2 kids. So I'm looking at short-term policies and hopefully will qualify for that. And I'll work my ass off to get a better job with better insurance these next 11 months.
gooseegg at February 24, 2016 9:46 AM
Not to harsh your lack of mellow Gooseegg, but it's only going to get worse. I was paying $250/head/month for a $13k deductible PPO. Apparently that was too cheap for BCBSoT to stay in business, so now they only offer HMO style plans that cost more with the same deductible. The big thing is I'm a contractor. I pay the full amount for my health insurance. So I know how much it truly costs.
Do any of you know how much your employer is paying per month of your premium costs? Goose was paying $300, but how much did the employer cover? A number of people have noted middle class take home pay hasn't risen for decades while upper class pay has. This is why. All those middle class pay raises have gone into the health insurance industry without employees noticing.
Ben at February 24, 2016 2:21 PM
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