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Though it is true that health insurance premiums will cost less under President Obama’s health care plan, it is also true that there will be fewer choices and that insurers will limit the choice of doctors and hospitals available to consumers, according to the NY Times.
Across the country, from California to Maine and the midwest in-between, insurance companies are lowering premiums but are along with it “restricting the number of providers who will treat patients in their new health plans.”
Most people who will look for coverage will be in the low to moderate-income bracket, and these price sensitive consumers will look for affordability primarily. Insurers have created the perfect solution where they can meet the needs of the price sensitive consumers without going bust themselves. They will have smaller networks of doctors, fewer doctors, and fewer hospitals. In many cases as well, the health care providers will also be paid less.
The public is concerned; health care providers are also concerned. Health policy analyst Adam Linker of the North Carolina Justice Center comments that consumers have to be ready for a much smaller group of hospitals and doctors. This policy may “hold down premiums” and it might drive people to “higher quality providers.” Health advocate Mr. Linker is wary as he feels that “there is also a risk [that] under some health plans, consumers can end up with astronomical costs if they go to providers outside the network.”
Insurance companies note that with fewer doctors and hospitals, costs are controllable and the insurers have more control over quality of care provided. They also note that having coverage although in a smaller network of providers is much better than having no coverage at all.
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Executive vice president of Blue Shield of California noted that his new health network is half the size of his former one, and the best hospitals were excluded. Daniel Hawkins Jr., a senior vice president of the National Association of Community Health Centers commented, “we serve the very population that will gain coverage- low income, working class uninsured people. But insurers have shown very little interest in including us in their provider networks.”
Dr. Bruce Siegel, president of America’s Essential Hospitals formerly known as the National Association of Public Hospitals and Health Systems said that insurers told his members, “we don’t want you in our network. We are worried about having your patients who are sick and have complicated conditions.”
David Sandor, vice president of the Health Care Service Corporation, offering Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas commented, “in the health insurance exchange, most individuals will be making choices based on costs. Our exchange products will have smaller provider networks that cost less than bigger plans with a larger selection of doctors and hospitals.”
