Tuesday, October 01, 2013

Welcome to the New Health Care

As seen a Boston Logan airport this weekend:

Welcome to the New Health Care (Click to enlarge)
As of 10:15 pm on 30 Sep 2013, the official Illinois insurance exchange website with its reported 165 options for health care coverage called GetCoveredIllinois.gov  (and run by the Federal government) has yet to launch.

I wish I could have critiqued the site and the health plan offerings with their out-of-pocket costs for the Big Day.

But it was not to be.

The great irony in all of this is that really, nothing is new.  Everything, it seems, remains cloaked in secrecy.

Oh sure there are things called "exchanges" now.  And millions upon millions of dollars will be spent on internet, social media, TV, print, and radio advertising touting the law.  There will be counselors there to help people make an "informed" choice.  But there's still a new complicated, unreadable law that promises much, but delivers, well, we're still not really sure.  There have been so many promises, but no one knows (yet) what we've given up in return for the monstrous bureaucracy, new payments, and massive consolidation of doctors offices and hospital systems that this law has already created.  Oh sure, the least risky adult population under 26 can stay on insurance, but now millions of young people who make $20,000 per year will be signing up for something that costs one tenth of their salary annually ($163 / month x 12) and have no idea in the world what they're getting (really) for their money.  Oh, sure, they get well doctor visits, but what does Insurance Company B have over Insurance Company C, or company Z?  Why do people have to add a zip code on their websites - have some areas gotten political favors in exchange for lower costs when others don't?

No one has a clue.

And that will total out of pocket costs really be in terms of "co-pays" and "co-insurance" kick in?  What happens when an insurance company refuses to pay for a service because it wasn't the service they chose for people covered in their plans?

No one has a clue.

And how long will people have to wait for an appointment after 1 January 2014 for their Medicaid care, in a system that already can't pay its bills?  If my clinic's any indication: today, this minute, it's already a two and a half month wait for a routine follow-up appointment.

You see, there are only so many of us, and millions more patients on their way to Great Expectations now.  But as the new law has been taking shape, there has been downsizing, trimming of staff, more work for those who remain, and lots of doctors and nurses dropping out, moving on, or retiring early because they've been given sweet deals, or really had no choice.  Many are already frustrated, burned out, or getting to the point (sadly) that they really don't care any more as more an more administrators are hired to tell health care workers how to work without doing the real work themselves.

So things will have to change under they weight of it all and they will.

But for now, it's all "new," so enjoy.



  1. Will the plans have any "in network doctors?" No one has a clue.

    Our group has chosen not to contract with any "exchange plans" this quarter. We have no information about what will be reimbursed, what diagnostics will be covered, what chemotherapies will be covered. Rather than accept patients only to later learn that we can not care for them under the terms of the insurance, we are not taking them UNTIL we know what the contract states. Unlike our federal government, we do not sign the contract only to learn later what is in it.

  2. First, it's a damn sight better than what any Republican administration has ever provided. Second, you need to a little more research. The exchanges were to open on October 1. 10:15 on 9/30 is still not 10/1. Folks on the exchanges will not be paying 10% of their salary. 9.5% is tops and you seem to have forgotten that there are government subsidies involved. Your zipcode comment is appalling. Every single doc I have ever gone to requires a zipcode. Should I suggest they have kickback schemes? I'll tell you what these people DO know. They know they have insurance, they are covered with pre-existing conditions, they will not be bankrupted by medical bills, they can GO TO A DOCTOR WHEN THEY ARE SICK. I know....what a horrible idea.


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