And So It Begins: Sick Kids Being Denied Specialty Treatment Under ObamaCare

[william the wie]

The data on deaths, bankruptcies and disabilities caused by ACA will start firming up by the end of June due to required financial or other reports and then get increasing coverage thereafter.

 

[Greenbeard]

The ultimate problem with US health care is not Obamacare. It is the many problems with private for profit insurance and a hybrid system that has all of the negatives of private enterprise without the benefits and all the negatives of a public system without all of the benefits. The one saving grace is really the fact we throw a ton of money at it and have a lot of talented people working in the field.

The problem, if these anecdotes and selective outrage can be generalized, is that each day we find out people, left and right, hate private insurance.

In a marketplace with multiple insurers and multiple providers, not every insurer and provider have to contract with each other. Providers can choose not to accept Insurer X, and likewise insurer X can choose not to include Provider Y in its network.

That means the consumer has to shop for an insurance plan that has the features he wants, including this or that provider in-network. If people can't or won't shop, or they want every single provider in-network, then this kind of market-based system isn't going to work. If people are ultimately going to demand that everyone has access to a network of all providers, all hospitals, then they're going to end up demanding a single insurer with a single comprehensive network. I'll admit I wasn't expecting that.

 

[oreo]

The ultimate problem with US health care is not Obamacare. It is the many problems with private for profit insurance and a hybrid system that has all of the negatives of private enterprise without the benefits and all the negatives of a public system without all of the benefits. The one saving grace is really the fact we throw a ton of money at it and have a lot of talented people working in the field.

The problem, if these anecdotes and selective outrage can be generalized, is that each day we find out people, left and right, hate private insurance.

In a marketplace with multiple insurers and multiple providers, not every insurer and provider have to contract with each other. Providers can choose not to accept Insurer X, and likewise insurer X can choose not to include Provider Y in its network.

That means the consumer has to shop for an insurance plan that has the features he wants, including this or that provider in-network. If people can't or won't shop, or they want every single provider in-network, then this kind of market-based system isn't going to work. If people are ultimately going to demand that everyone has access to a network of all providers, all hospitals, then they're going to end up demanding a single insurer with a single comprehensive network. I'll admit I wasn't expecting that.

There are NO CHOICES with Obamacare. Think of Obamacare as a nationwide GROUP insurance policy. The only choice is the deductible you want--to lower your premiums. These are the mandates--and people like the parents of this sick kid are finding out that he's not covered under Obamacare--(for speciality treatment) that is at every single Children's hospital in this country.

They're in a Children's hospital in the first place--because they have a serious- often times- life threatening illness or injury that needs to be treated by specialists.

Specialists ARE NOT Covered under Obamacare--nor can the parents ill afford a specialist.

Now these Specialists WERE covered under private insurance plans before democrats and Obama got their hands on the health care industry in this country--and rewrote the insurance mandates for insurers.

I know--my daughter is a pediatric nurse practitioner who works at a Children's hospital.

Welcome to your hope and change!

 

[Politico]

The objective isn't to provide insurance to people.

It's to withhold treatment.

True that.

 

[mudwhistle]

If the goal was to get doctors to stop treating medicare patients then we can consider it a victory for Obamacare.

My wife broke her arm a few weeks ago and the walk-in clinic told her they don't take any government provided insurance anymore. Not Medicare, not Aetna, nothing.

I think it has something to do with not trusting that the government will pay claims.

It appears that Obamacare has caused more problems than it ever will solve. Perhaps it's because we have a president that can't tell the truth, so why should anyone trust any program he's involved in.

 

[mudwhistle]

The ultimate problem with US health care is not Obamacare. It is the many problems with private for profit insurance and a hybrid system that has all of the negatives of private enterprise without the benefits and all the negatives of a public system without all of the benefits. The one saving grace is really the fact we throw a ton of money at it and have a lot of talented people working in the field.

The problem, if these anecdotes and selective outrage can be generalized, is that each day we find out people, left and right, hate private insurance.

In a marketplace with multiple insurers and multiple providers, not every insurer and provider have to contract with each other. Providers can choose not to accept Insurer X, and likewise insurer X can choose not to include Provider Y in its network.

That means the consumer has to shop for an insurance plan that has the features he wants, including this or that provider in-network. If people can't or won't shop, or they want every single provider in-network, then this kind of market-based system isn't going to work. If people are ultimately going to demand that everyone has access to a network of all providers, all hospitals, then they're going to end up demanding a single insurer with a single comprehensive network. I'll admit I wasn't expecting that.

Shopping really means paying.

Of course if you pay more you can get more.


Obamacare wasn't intended to work, not in it's current form. There is no incentive to make it work. The only thing they want is to force everyone into one system called single-payer with no other competition. Say goodbye to independent private insurance companies.

Anyone who doesn't toe the line the government mandates, insurers, doctors, hospitals, patients, everyone involved, you don't get covered, and thus no treatment. If the government decides that owning a gun is a condition of your coverage then you don't have any until you get rid of your guns.

 

[Politico]

The goal of the gubbermint has always been hoping you will die before they have to pay you.

 

[mudwhistle]

The goal of the gubbermint has always been hoping you will die before they have to pay you.

Well, the high deductible assures that.

 

[Greenbeard]

There are NO CHOICES with Obamacare.

Of course there are, that's the problem the people in the OP are having.

If I'm single person looking for a plan on Washington's exchange (the WA Healthplanfinder), I can choose a plan that doesn't have Seattle Children's in-network. That's a specialty hospital that likely commands pretty high reimbursements and if I don't want a plan that's making payouts to them I can buy one. That doesn't mean there won't be pediatric specialists in the plan I choose (there will), it means that particular facility won't be in-network.

Similarly, if I'm shopping for a plan and I do want Seattle Children's in-network because I have a child (particularly one with a rare condition), then I would choose one of the exchange plans that retains them in its network (in the WA Healthplanfinder, that's any plan sold by Group Health, Community Health Plan of Washington aka Community HealthEssentials, or Molina Healthcare of Washington).

Apparently the people in the OP weren't savvy enough shoppers to select the plan that best met their needs and preferences. Maybe, like you, they were misinformed into thinking every plan is the same thing, there aren't any choices, and shoppers don't have any opportunities or responsibilities to examine their options and make an informed choice. Shopping really isn't that hard.

 

[mudwhistle]

B

 

[mudwhistle]

There are NO CHOICES with Obamacare.

Of course there are, that's the problem the people in the OP are having.

If I'm single person looking for a plan on Washington's exchange (the WA Healthplanfinder), I can choose a plan that doesn't have Seattle Children's in-network. That's a specialty hospital that likely commands pretty high reimbursements and if I don't want a plan that's making payouts to them I can buy one. That doesn't mean there won't be pediatric specialists in the plan I choose (there will), it means that particular facility won't be in-network.

Similarly, if I'm shopping for a plan and I do want Seattle Children's in-network because I have a child (particularly one with a rare condition), then I would choose one of the exchange plans that retains them in its network (in the WA Healthplanfinder, that's any plan sold by Group Health, Community Health Plan of Washington aka Community HealthEssentials, or Molina Healthcare of Washington).

Apparently the people in the OP weren't savvy enough shoppers to select the plan that best met their needs and preferences. Maybe, like you, they were misinformed into thinking every plan is the same thing, there aren't any choices, and shoppers don't have any opportunities or responsibilities to examine their options and make an informed choice. Shopping really isn't that hard.

This us one of the problems with governmental involvement in anything. After working inside government in one capacity or another since 1974 I discovered that they can take anything simple and turn it into a complicated mess.

We have choices, but the trick is trying to navigate thru the bureaucracy. And what it really boils down to is this is not what we were promised. I mentioned this long ago. What if it's all a lie. Well, several of the promises have turned out to be lies.

Let's not forget that the biggest hurdles in running a business today is government intrusion. Regulations. The more confusing, the more mistakes can be made. Doctors will face mountains of paperwork and dump patients, only treating those without the complications.

 

[emilynghiem]

There are NO CHOICES with Obamacare.

Of course there are, that's the problem the people in the OP are having.

If I'm single person looking for a plan on Washington's exchange (the WA Healthplanfinder), I can choose a plan that doesn't have Seattle Children's in-network. That's a specialty hospital that likely commands pretty high reimbursements and if I don't want a plan that's making payouts to them I can buy one. That doesn't mean there won't be pediatric specialists in the plan I choose (there will), it means that particular facility won't be in-network.

Similarly, if I'm shopping for a plan and I do want Seattle Children's in-network because I have a child (particularly one with a rare condition), then I would choose one of the exchange plans that retains them in its network (in the WA Healthplanfinder, that's any plan sold by Group Health, Community Health Plan of Washington aka Community HealthEssentials, or Molina Healthcare of Washington).

Apparently the people in the OP weren't savvy enough shoppers to select the plan that best met their needs and preferences. Maybe, like you, they were misinformed into thinking every plan is the same thing, there aren't any choices, and shoppers don't have any opportunities or responsibilities to examine their options and make an informed choice. Shopping really isn't that hard.

Dear Greenbeard: If the point is better choices, why does the ACA penalize other choices?
State innovations aren't viable choices until 2017. This is to discourage the choice to invest in better alternatives. The mandates force people under restricted plans.

The same funds and resources that could be invested in hospitals, clinics and medical programs and education
are REQUIRED to go into INSURANCE which doesn't develop ANY OF THESE PROVISIONS.

So the laws force tax dollars into insurance
and take those same resources AWAY from
developing programs that can provide health care on a sustainable basis.

Why not REWARD taxpayers and businesses for investing directly in
developing health care facilities and provisions?

Wouldn't that serve more people directly instead of going through
an insurance middle man designed to make money WITHOUT PROVIDING ANY SERVICES.

 

[william the wie]

There are NO CHOICES with Obamacare.

Of course there are, that's the problem the people in the OP are having.

If I'm single person looking for a plan on Washington's exchange (the WA Healthplanfinder), I can choose a plan that doesn't have Seattle Children's in-network. That's a specialty hospital that likely commands pretty high reimbursements and if I don't want a plan that's making payouts to them I can buy one. That doesn't mean there won't be pediatric specialists in the plan I choose (there will), it means that particular facility won't be in-network.

Similarly, if I'm shopping for a plan and I do want Seattle Children's in-network because I have a child (particularly one with a rare condition), then I would choose one of the exchange plans that retains them in its network (in the WA Healthplanfinder, that's any plan sold by Group Health, Community Health Plan of Washington aka Community HealthEssentials, or Molina Healthcare of Washington).

Apparently the people in the OP weren't savvy enough shoppers to select the plan that best met their needs and preferences. Maybe, like you, they were misinformed into thinking every plan is the same thing, there aren't any choices, and shoppers don't have any opportunities or responsibilities to examine their options and make an informed choice. Shopping really isn't that hard.

If they were using the navigator system as pretty much required by the law you may be blaming the wrong people. Except for computer literate political junkies like those on this board I have heard no good reports of any ACA exchanges.

 

[william the wie]

There are NO CHOICES with Obamacare.

Of course there are, that's the problem the people in the OP are having.

If I'm single person looking for a plan on Washington's exchange (the WA Healthplanfinder), I can choose a plan that doesn't have Seattle Children's in-network. That's a specialty hospital that likely commands pretty high reimbursements and if I don't want a plan that's making payouts to them I can buy one. That doesn't mean there won't be pediatric specialists in the plan I choose (there will), it means that particular facility won't be in-network.

Similarly, if I'm shopping for a plan and I do want Seattle Children's in-network because I have a child (particularly one with a rare condition), then I would choose one of the exchange plans that retains them in its network (in the WA Healthplanfinder, that's any plan sold by Group Health, Community Health Plan of Washington aka Community HealthEssentials, or Molina Healthcare of Washington).

Apparently the people in the OP weren't savvy enough shoppers to select the plan that best met their needs and preferences. Maybe, like you, they were misinformed into thinking every plan is the same thing, there aren't any choices, and shoppers don't have any opportunities or responsibilities to examine their options and make an informed choice. Shopping really isn't that hard.

This us one of the problems with governmental involvement in anything. After working inside government in one capacity or another since 1974 I discovered that they can take anything simple and turn it into a complicated mess.

We have choices, but the trick is trying to navigate thru the bureaucracy. And what it really boils down to is this is not what we were promised. I mentioned this long ago. What if it's all a lie. Well, several of the promises have turned out to be lies.

Let's not forget that the biggest hurdles in running a business today is government intrusion. Regulations. The more confusing, the more mistakes can be made. Doctors will face mountains of paperwork and dump patients, only treating those without the complications.

The debate will change as deathrates due to ACA firm up throughout the year. Although the WA screw up is a bit of a surprise since their last healthcare exchange closed only 15 years ago this is normal political stuff that will get corrected. The Hispanic deathrate due to ACA will be critical later this year and in 2016.

 

[Antares]

Do you have proof that these patients who were denied treatments had insurance coverage that wouldn't have denied them before this?

NO, you don't.

This wasn't going to happen anymore right?? and you don't have proof the didn't NO you don't. see how that works

Why would I have to prove a negative?

Too funny, the answer is NO this wasn't supposed to happen anymore and you know it piss ant.

Protect the KIng at all costs, even your non existent integrity.

 

[Antares]

There are NO CHOICES with Obamacare.

Of course there are, that's the problem the people in the OP are having.

If I'm single person looking for a plan on Washington's exchange (the WA Healthplanfinder), I can choose a plan that doesn't have Seattle Children's in-network. That's a specialty hospital that likely commands pretty high reimbursements and if I don't want a plan that's making payouts to them I can buy one. That doesn't mean there won't be pediatric specialists in the plan I choose (there will), it means that particular facility won't be in-network.

Similarly, if I'm shopping for a plan and I do want Seattle Children's in-network because I have a child (particularly one with a rare condition), then I would choose one of the exchange plans that retains them in its network (in the WA Healthplanfinder, that's any plan sold by Group Health, Community Health Plan of Washington aka Community HealthEssentials, or Molina Healthcare of Washington).

Apparently the people in the OP weren't savvy enough shoppers to select the plan that best met their needs and preferences. Maybe, like you, they were misinformed into thinking every plan is the same thing, there aren't any choices, and shoppers don't have any opportunities or responsibilities to examine their options and make an informed choice. Shopping really isn't that hard.

If they were using the navigator system as pretty much required by the law you may be blaming the wrong people. Except for computer literate political junkies like those on this board I have heard no good reports of any ACA exchanges.

They aren't required to use anybody to help them, they are free to do it themslves.