In Sonoma County, a man is battling more than a dozen tumors in his body.
Oh, and now he is fighting a different battle, says CBS News, with his insurance carrier, Anthem Blue Cross.
While open enrollment for coverage under the Affordable Care Act is closed, many of the newly insured are finding they can’t find doctors, landing them into a state described as “medical homelessness.”
Rotacare, a free clinic for the uninsured in Mountain View, is dealing with the problem firsthand.
When Blue Shield of California was designing the new health plans it would offer individuals under the Affordable Care Act (ACA), the insurer made a simple request to doctors and hospital in its network — lower your prices or get left behind. The insurer asked providers to accept reimbursement rates as much as 30 percent lower than what Blue Shield previously paid through plans sold on the individual market. Keep in mind that billing through a third-party-payer is about to multiply tenfold in complexity (from ~15,000 to +155,000 billing codes with ICD-10), meaning that getting paid will require more work for fee-for-service docs. In fact, providers are attending training seminars, paid for out of pocket, to learn how to deal with this billing beast.
Some providers got on board with Blue Shield, but not all of them.
Fox News conducted a hard interview with a doctor in California. All things considered, we’re aware of the network’s general political leanings, and we’re not politicians at Atlas MD (we’re doctors). However, it’s very difficult to argue with the fact that paying subscribers have been kicked off of existing plans in California, and forced into Obamacare programs. Regardless of whether one plan is better than the other, one thing has been eliminated, and that’s the power of choice.
Had we been invited to the program we might have added that the insurance doesn’t guarantee quality care. Quality care is something that takes time and experience. The more fee-for-service doctors deal with insurance to get paid, the less medicine they actually practice. In a perfect world, there’d be MORE doctors, not more red tape. Ironically, as we add more bureaucratic influence, albeit well intentioned, we run the risk of running doctors out of medicine entirely.
Sadly, the government imagines medicine like this — insure everyone, problem solved. But what happens when all the doctors are occupied, and there’s no one to see all these insured patients?
According to AP, “New research suggests giving patients easier-to-take medicine and no-copay medical visits can help drive down high blood pressure, a major contributor to poor health and untimely deaths nationwide.” They released a new article highlighting the optimistic results. This is a major win for common sense, something direct care has been sticking up for years now. If people don’t have to pay to come in to the doctor, they will see the doctor. Of course, we want to toast these findings with everything in the cabinet. But, to be fair, let’s go over what actually happened in the study.