Terri Durheim and her family now have health insurance, courtesy of Obamacare. But what they don’t have are local doctors and hospitals who will take it.
This worries the Enid, Okla., resident because she has a teenage son with a serious heart condition. Now they have to find a pediatric cardiologist in Oklahoma City. And that’s more than an hour away.
And if there’s an emergency … “obviously we’d have to pay out of pocket and go here in town, but that defeats the purpose of insurance. I’m truly grateful we have insurance. It’s reasonable and affordable, but it’s not doing me a lot of good,” said Durheim, who just had to drive 90 minutes to Stillwater, Okla., for a CAT scan for herself. “It’s so frustrating.”
This family is a prime example of someone who would have benefitted from a small monthly payment for direct care and wrap-around insurance. They would have a local doctor at their beck and call for most of what they need. AND they would have insurance to see a heart specialist. And they could negotiate to find a rate and coverage that would suit them. Unfortunately, they did like Uncle Sam wanted, and look where it took them.
Of course, insurance coverage is going to vary by plan and company. But on the free market, companies are competing to add value and make money. With Obamacare, that isn’t happening. Insurance providers are jumping through hoops to collect subsidies and stay away from tax penalties. They are not adding value as we see with these bronze and silver plans that yes, meet Obamacare’s rules for pricing and availability, but ARE NOT HELPFUL.
In effect the government has tied more red tape, and made things more expensive and less efficient.
But the cat’s out of the bag. Like Durheim, Americans enrolling on the Obamacare exchanges are quickly realizing they have access to a relatively limited set of doctors and hospitals. In many areas, the largest hospitals are not participating and many doctors are not accepting the coverage.
And remember, that’s by design. In order to keep premiums down for silver and bronze plans, insurers narrow the networks of doctors and hospitals, oftentimes excluding the priciest and most specialized providers.