Will Obamacare get its act together in time?

[Hauldren Collider]

It's hilarious that you think the Republicans were all communists.

Stalin was backing them. It's pretty obvious what would have happened had they won.

[Hauldren Collider]

Top hospitals opt out of Obamacare
The Obama administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven’t surveyed the nation’s top hospitals.

Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.

“This doesn’t surprise me,” said Gail Wilensky, Medicare director for the first Bush administration and senior fellow for Project HOPE. “There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money.”

Regulations driven by the Obama White House indeed have made insurance more affordable – if, like Kathleen Sebelius, you’re looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.

Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well.

The result of our investigation: Many top hospitals are simply opting out of Obamacare.

Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.

And that’s not because their exchanges don’t offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states’ premier hospitals — Cleveland Clinic and Cedars-Sinai Medical Center — have only one company in their respective networks.

A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers.

“Many companies have selectively entered the exchanges because they are concerned that (the exchanges) will be dominated by risky, high-using populations who wanted insurance (before Obamacare) and couldn’t afford it,” said Wilsensky, who is also on the board of directors of UnitedHealth. “They are pressed to narrow their networks to stay within the premiums.”

Consumers, too, will struggle with the new system. Many exchanges don’t even list the insurance companies on their web sites. Some that do, like California, don’t provide names of doctors or hospitals.

The price differences among hospitals “can be pretty profound,” said Joe Mondy, spokesman for Cigna insurance. “When you are doing a cost comparison with doctors, you should look up the quality of the hospital as well. Hospital ‘Y’ could be great at pediatrics and not great at surgery.”

Insurers operating in the exchanges apparently are hesitant to talk about the trade-off between price and quality. Two of the nation’s largest insurers — Wellpoint and Aetna — refused to respond to a dozen calls and emails placed during the course of a week.

Wellpoint and Aetna’s decision to not educate the public on its choices doesn’t sit well with two experts.

“There is no reason to keep that quiet. It’s not going to be a good secret for very long when people want to use the plans,” Wilensky said.

“In many cases, consumers are shopping blind when it comes to what doctors and hospitals are included in their Obamacare exchange plans,” said Josh Archambault, senior fellow with the think tank Foundation for Government Accountability. “These patients will be in for a rude awakening once they need care, and get stuck with a big bill for going out-of-network without realizing it.”

All of this represents a larger problem with the Affordable Care Act, said Archambault, who has studied the law extensively.

“It reflects deeper issues in implementation,” he said. “Some hospitals and doctors don’t even know if they are in the network.”

Just look at Seattle Children’s Hospital, which ranks No. 11 on the U.S. News & World Report best pediatric hospital list. When Obamacare rolled out, the hospital found itself with just two out of seven insurance companies on Washington’s exchange. The hospital sued the state’s Office of Insurance on Oct. 4 for “failure to ensure adequate network coverage.”

“Children’s is the only pediatric hospital in King County and the preeminent provider of many pediatric specialty services in the Northwest,” a hospital news release said. “ Some of these specialized services not available elsewhere in our area or region include acute cancer care, level IV neonatal intensive care and heart, liver and intestinal transplantation.”

And for doctors in Texas, “Basically, we don’t know,” said Stephen Brotherton, president of the Texas Medical Association. “We can’t find out. At this point, it’s part of the various unknowns with the marketplace. There are ways you can be on plans and not even realize it.”

http://watchdog.org/114137/top-hospitals-opt-out-of-obamacare/

[kentonio]

Stalin was backing them. It's pretty obvious what would have happened had they won.

So were the French, what's your point?

[Ogie Oglethorpe]

Bonus - get to hang out with Hemmingway.

Somehow I don't get all tingly and jazzed about hanging out with sexist homophobic drunkards. Might as well just go to a Alabama football tailgate.

[Imran Siddiqui]

Sexist homophobic drunkards described like 90% of Americans back then.

[Ogie Oglethorpe]

Also forgot he was a forgone racist to boot.

[Sava]

Sexist homophobic drunkards described like 90% of Americans back then.

and now only 90% of Republicans

progress

[Guynemer]

Somehow I don't get all tingly and jazzed about hanging out with sexist homophobic drunkards. Might as well just go to a Alabama football tailgate.

Roll Tide.

[The Mad Monk]

I've never heard of county restricted plans before. I'm not sure why San Diego wouldn't be offering an Anthem (which I assume is a BC/BS product) PPO plan.

She was written up in the AARP Newsletter, among other publications, about this time last year.

[C0ckney]

Stalin was backing them. It's pretty obvious what would have happened had they won.

you have no idea what you are talking about.

seriously, please go and educate yourself about the spanish civil war. a good and very detailed account is hugh long's 'the spanish civil war'.

while you're at it, you should probably read up on chile and iran as well.

[Ben Kenobi]

You've always got a hard-on for colonialism.

I'm not the one living in a former colony.

I think the US should have granted the Philippines independence at the end of the Spanish American war. Instead we ended up fighting against the people we were supposedly trying to "help", and for even less good reason than in Vietnam. (Since the Filipinos weren't Communists or allied with our enemies.)

Never said they were, but I maintain that US association with the Phillippines has been beneficial for both the US and the Phils.

The US fighting against Japan later was a rather different situation, since the Philippines wasn't fighting against the US.

It's still substantial intervention on behalf of the Phillipines.

If the US doing the right thing at the end of the Spanish American war lead to me not being able to live my life this way ... so be it. Unlike you I don't think a whole nation should be subjugated for my own benefit.

Canada was a colony too. So was the US - they didn't become independent right off the bat - and in Canada's case - it's debatable whether Canada's been as independent as the Philippines. The Phils weren't a democracy when the US took over, but they were one when the US left.

[giblets]

I'm not the one living in a former colony.

When did you leave Texas?

[regexcellent]

Republican Spain more often goes Allies than Comintern in Hoi3, but I'd frankly rather Nationalist Spain win because beating the Soviet Union is way harder than beating Nazi Germany, which is ridiculously easy. Not having to put troops on the Spanish border of France helps a ton.

(The biggest issue with beating Nazi Germany though is that Britain never does its ****ing job. Seriously it just needs to do 4 things, not lose Gibraltar, not lose Egypt, not lose Britain, and stop the Germans from invading Norway)

[giblets]

Do you always play as the USA or something?

[regexcellent]

Usually. I've also played as Germany, France, and Britain, and Australia. USA is fun because you can get compound interest out of your ICs and run up a 50%+ construction practical before the war starts.