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PoliticAverse

(26,366 posts)
Fri Nov 22, 2013, 02:51 AM Nov 2013

Insurers restricting choice of doctors and hospitals to keep costs down

As Americans have begun shopping for health plans on the insurance exchanges, they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.

The Obama administration made it a priority to keep down the cost of insurance on the exchanges, the online marketplaces that are central to the Affordable Care Act. But one way that insurers have been able to offer lower rates is by creating networks that are far smaller than what most Americans are accustomed to.

The decisions have provoked a backlash. In one closely watched case, Seattle Children’s Hospital has filed suit against Washington’s insurance commissioner after a number of insurers kept it out of their provider networks. “It is unprecedented in our market to have major insurance plans exclude Seattle Children’s,” said Sandy Melzer, senior vice president.

The result, some argue, is a two-tiered system of health care: Many of the people who buy health plans on the exchanges have fewer hospitals and doctors to choose from than those with coverage through their employers.

Read the rest at: http://www.washingtonpost.com/national/health-science/insurers-restricting-choice-of-doctors-and-hospitals-to-keep-costs-down/2013/11/20/98c84e20-4bb4-11e3-ac54-aa84301ced81_story.html

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Insurers restricting choice of doctors and hospitals to keep costs down (Original Post) PoliticAverse Nov 2013 OP
Who didn't know this was coming? n/t JimDandy Nov 2013 #1
Been going on for 25 years. postulater Nov 2013 #2
Well, they have to screw someone, or they won't make the big bucks. nt bemildred Nov 2013 #3
I have never had a health plan that didn't have restrictions on who you could see, SheilaT Nov 2013 #4
So are the doctors to blame or the insurance companies? flamingdem Nov 2013 #5
 

SheilaT

(23,156 posts)
4. I have never had a health plan that didn't have restrictions on who you could see,
Fri Nov 22, 2013, 02:28 PM
Nov 2013

or what authorization was needed to see a specialist. Never. The only completely free access to medical care was the old fee for service one, where you paid in full for whatever. And even then, there were times I knew of when particular doctors weren't taking on new patients because they had as many as they could handle.

flamingdem

(39,313 posts)
5. So are the doctors to blame or the insurance companies?
Fri Nov 22, 2013, 10:44 PM
Nov 2013

In this case it looks like the insurance companies are playing games to screw the consumer. Do they decide on payment amounts?

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