…with their junk policies before Obamacare came along and fixed it for you.
From an article in the WSJ by Edie Sundby, who suffers from gallbladder cancer and yet has outlived her original dire prognosis by years:
Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team. The company pays a fair price to the doctors and hospitals, on time, and is responsive to the emergency treatment requirements of late-stage cancer. Its caring people in the claims office have been readily available to talk to me and my providers.
But in January, United Healthcare sent me a letter announcing that they were pulling out of the individual California market. The company suggested I look to Covered California starting in October.
You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so. UCSD has agreed to accept only one Covered California plan””a very restrictive Anthem EPO Plan. EPO stands for exclusive provider organization, which means the plan has a small network of doctors and facilities and no out-of-network coverage (as in a preferred-provider organization plan) except for emergencies. Stanford accepts an Anthem PPO plan but it is not available for purchase in San Diego (only Anthem HMO and EPO plans are available in San Diego).
So if I go with a health-exchange plan, I must choose between Stanford and UCSD. Stanford has kept me alive””but UCSD has provided emergency and local treatment support during wretched periods of this disease, and it is where my primary-care doctors are.
Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines.
Edie’s dilemma is not just about premiums being lower or higher pre- and post-Obama; it is about physician and hospital availability, which will affect people who buy on the exchanges, because (at least as far as I can determine) the vast majority of the exchange policies limit choice to doctors and hospitals in approved networks. And in many places the networks are far more restrictive than people’s policies were before.
As yet, most people have no idea about this consequence of Obamacare; it is the Obamacare boot (in more ways than one) that has yet to drop. So far I can’t recall seeing a piece from a pro-Obamacare pundit that factors it in or deals with it at all. However, I’m almost certain that if and when they do get around to acknowledging the phenomenon, they—and President Obama—will blame it (once again) on the insurance companies doing the limiting, and claim they’re doing it just to greedily maximize their take above and beyond what’s needed (although why this behavior should suddenly have taken such a jump post-Obamacare, and why many companies wouldn’t want to offer more choices than their competitors, and thus attract more customers, I don’t know).
But Obama and his progressive supporters will almost undoubtedly use their stock response that any and all negative post-Obamacare changes are not the result of Obamacare itself but are instead opportunistic grabs by the insurance companies wishing to screw customers still further. For Obama to ignore the math of how the insurance business actually works—that you can’t add coverage to a policy without increasing costs to the consumer, or limiting coverage in another area of that policy—is okay with many of his supporters, who don’t seem to understand the way insurance works, as well.
And if everything bad about Obamacare can be blamed on greedy insurers, the next step, of course, is to eliminate those insurers from the equation by going to public option or single payer. Public option drives out private insurers somewhat more slowly than single payer, but it tends to get there all the same.
I’ll close by reproducing here a response to Sundby’s piece from a commenter named Michael Kaiser (can’t figure out how to give a direct link to the comment, but it’s one of the earliest, on page 1 of the comments to the article):
No offense guy, but you have gotten much more than you have deserved. Over a million dollars spent on care at multiple world-class providers. And now you actually are complaining that you can not keep it all forever? Situations like yours are at the core of what is wrong with our healthcare system and our planet as well. We can not afford to keep everyone alive and well fed, etc. forever no matter what. Furthermore, end-stage care makes up a disproportionate amount of medical dollars spent. How much more do you think society–and ultimately it is society–should spend to try to keep you in the 2%?
Aside from its intense mean-spiritedness, it shows a complete lack of understanding about how insurance actually works. Health care insurance has come so far from its basic roots that I suspect he may even genuinely not understand the simplest principles of insurance; hard to tell. But look for attitudes like his to become more and more prevalent and more frequently voiced: if you get something, you are by definition taking it away from me and you don’t deserve more than I get.
In this, as in so many many other things, we can hardly do better than to turn to the words of Winston Churchill. For “socialism” you can substitute “progressivism” if you wish:
Socialism is a philosophy of failure, the creed of ignorance, and the gospel of envy, its inherent virtue is the equal sharing of misery.
[ADDENDUM: Excellent posts here and here by Ace.]
[ADDENDUM II: And Think Progress jumps in with the inevitable “She didn’t lose her insurance because of Obamacare, she lost it because of the insurance company” defense, thus missing one of the most important points of Sundby’s article (not that I think they really missed it; I think they purposely distorted it). Her problem is that the exchanges limit the doctors and hospitals that people can go to much more than most older policies do, and this is true whether you had a policy that was canceled (as Sundby did) or are coming to the exchanges for other reasons. She is warning people that money isn’t the only thing that will change about coverage, it’s access and choice.
The White House’s Dan Pfeiffer approvingly cites the Think Progress article. No surprise there, either.]