Patterico's Pontifications

2/21/2014

Another Problem with ObamaCare in California: People Can’t See a Doctor

Filed under: General — Patterico @ 7:44 am

I recently debunked the idea that California is doing great on health care insurance. Not so, despite announcements that an enrollment target had supposedly been met. Here’s another issue: just because you’re enrolled doesn’t mean you get to see a doctor.

One viewer said she did months of research before picking the plan that Blue Cross recommended. But it’s still been a nightmare.

Katherine Cadman says her emails and calls aren’t getting anywhere. She says she signed up for an Anthem Blue Cross Plan, but doctors keep refusing to see her.

“It’s just not right,” she said. “It does make you feel like you’re a second-class citizen.”

See, doctors don’t like the reimbursement rates, so many refuse to see ObamaCare patients (just like they refused to see Medicare patients). The government has not forced doctors to see these patients.

Yet.

Ed Morrissey says:

The laws of supply and demand, and cost and pricing, do not get wished away or legislated out of existence.

Yet.

38 Comments

  1. When Belgium nationalized health care in the 50′s the country was involved in a bloody colonial war in the Congo. Understanding clearly that they had to get the Doctors on board the Government offered them a choice. Sign up for the health service or be drafted and sent to the Congo as foot soldiers.

    Comment by Glenn (647d76) — 2/21/2014 @ 8:50 am

  2. Ah, the good old days, Glenn. Each according to his ability to each according to his need, when the Revolution was still young and rosy-fingered Utopia lit the beautiful horizon of Socialism.

    Comment by nk (dbc370) — 2/21/2014 @ 8:59 am

  3. When I took my son to see his pediatrician a few months ago, I ask: “So doc, what do you think of Obamacare?” The otherwise cheerful doctor responded: “You mean the Afordable Care Act? I don’t know. We’ll have to wait and see.” Okay.

    Then, more, recently I asked my own physician the same question and got an identical response. It left me wondering if these guys are reading from the same script. The question seemed to deflate both of them.

    I take this as a bad sign.

    We’re Californians too.

    Comment by ThOR (130453) — 2/21/2014 @ 9:37 am

  4. From the article:

    He says an in-network doctor turned him down…..

    ….When we again reached out to Anthem again for answers on Wednesday and they issued the following statement:

    “Our records indicate that this doctor has a contract with Anthem Blue Cross to treat our Covered CA members, and we will reach out to him to determine what the issue is.”…

    ….Anthem tells CBS13 it can’t force an in-network doctor to give care, and that the doctor can terminate its contract.

    Are these two different statements, or can he refuse to see a new patient only if he cancels his contract?

    Or maybe he can limit himself to existing patients? Or he can refuse anyone, but must give non-financial reason? Or what?

    This is verging on consumer fraud, certainly without a notice that these doctors may or may not agree to treat you.

    Comment by Sammy Finkelman (3015b5) — 2/21/2014 @ 9:42 am

  5. MNSure has an advert on their success clogging the breaks between Olympic coverage.

    This youngish lady got a brain tumor and couldn’t return to work. Hubby evidently can’t cover her either.

    She recounts discovery of the MNSure option, she “couldn’t believe it was real”.

    Guess what, dearie? Don’t think about saving for retirement. You’ll owe your soul to the company store.

    Comment by gary gulrud (e2cef3) — 2/21/2014 @ 9:47 am

  6. Then there’s the Covered CA tack of listing doctors as participating when there’s no contract in hand.

    Ooopsie. Obama happens.

    Comment by gary gulrud (e2cef3) — 2/21/2014 @ 9:52 am

  7. No offense, but (yeah, I know) is this an Obamacare problem or a California problem? We are talking about a state that’s dysfunctional in just about everything, after all.

    Comment by nk (dbc370) — 2/21/2014 @ 10:20 am

  8. Meanwhile, the website has been down for about 2 days.

    https://www.coveredca.com/maintenance/

    Comment by JoeH (7b5d32) — 2/21/2014 @ 10:28 am

  9. Shockah! People discover that health insurance and health care aren’t the same thing, despite the fact that Pelosi/Reid/Obama & Co. deliberately conflated the two.

    https://www.coveredca.com/

    Your destination for affordable, quality health care, including Medi-Cal

    Comment by Steve57 (a7ff60) — 2/21/2014 @ 10:46 am

  10. 7. …We are talking about a state that’s dysfunctional in just about everything, after all.

    Comment by nk (dbc370) — 2/21/2014 @ 10:20 am

    Obama sees that as a model for the nation. No, it’s not just Kali’s problem anymore.

    Comment by Steve57 (a7ff60) — 2/21/2014 @ 10:47 am

  11. I dunno, Steve. I think there will be a lot more “men” seeking OB/GYN care in San Francisco than in Chicago.

    Comment by nk (dbc370) — 2/21/2014 @ 10:52 am

  12. nk, I think you’re wrong.

    True, SF is the #1 LGBT friendly city in the US. But Chicago makes it onto the list at #12.

    http://www.ranker.com/list/most-gay-friendly-cities-in-america/carlybobarly

    And also SF has about 30% of the population of Chicago. So I figure in absolute terms more men will be seeking OB/GYN care in the Windy City than in Baghdad by the Bay.

    Comment by Steve57 (a7ff60) — 2/21/2014 @ 11:13 am

  13. Post today from one of my Internet friends re OBcare:

    “Heathcare nightmare story: I have a client who just told me that she has been battling her health insurance (they are military, so it is a government policy) since last October. She had a hip replacement in August 2013. Her doctor’s office got full approval before the surgery. In October they denied coverage. Yesterday, they demanded a refund for all the bills they accidently paid. When she called the insurance company, she was told, “We are the government, we can do anything we want.”

    “You should be frightened. Very frightened.”

    Comment by Judy Eaton (aee826) — 2/21/2014 @ 11:49 am

  14. I’ll have you know that we in California have a wealth of veterinarians. Problem solved!

    Comment by Colonel Haiku (f5f7a0) — 2/21/2014 @ 11:55 am

  15. LGBT friendly city

    T’s are just tacked on the end there like a sewed-on fake penis made out of ass cartilage or god knows what but they don’t really belong in the same group as the L’s and the G’s and the B’s

    Comment by happyfeet (c60db2) — 2/21/2014 @ 11:56 am

  16. girls will be boys and
    boys will be girls a mixed up
    muddled shook up world

    Comment by Colonel Haiku (f5f7a0) — 2/21/2014 @ 12:01 pm

  17. Even before this obamination, in-network doctors sometimes did not accept new patients. The insurance companies would list “accepting new patients” on their site as a search criterion.

    Now, whether they could accept new patients from some plans and not others is unclear and probably detailed in the plan or master contract they had with the insurer. The web sites do list doctors by plan and not just “takes Blue Cross” as BC has a number of plans and networks, but it can be hard to impossible to find this out ahead of time.

    When searching for a plan for my wife, I selected Blue Cross not because of what they said, but because the largest and most complete provider in my area (UCLA Healthcare) said on THEIR website that they would accept BC CoveredCA plans.

    Comment by Kevin M (dbcba4) — 2/21/2014 @ 1:49 pm

  18. Just to be annoying, you should create LGBTV, for vegitarian.

    Comment by Kevin M (dbcba4) — 2/21/2014 @ 1:50 pm

  19. vegetarian.

    Comment by Kevin M (dbcba4) — 2/21/2014 @ 1:51 pm

  20. Then, more, recently I asked my own physician the same question and got an identical response

    The reason you got that response was that the insurance companies wouldn’t give them a straight answer about contract terms at least as late as last October. They really DID have to wait and see.

    Comment by Kevin M (dbcba4) — 2/21/2014 @ 1:54 pm

  21. nk,

    This is likely a user problem. She looked at the website and selected some other non-ACA plan’s network when she was “doing her research.”

    It’s mostly just trying to blame the insurance companies for the narrow networks.

    “Good, fast, cheap. Pick any two”

    Comment by Kevin M (dbcba4) — 2/21/2014 @ 1:57 pm

  22. all large projects fall under the same rule

    on time
    on budget
    it w*rks

    you can have any 2 of the 3 options.

    with ACA, they selected “none of the above”… 8-)

    Comment by redc1c4 (abd49e) — 2/21/2014 @ 2:21 pm

  23. Yeah, surprise, surprise. So much pundit and politician talk about insurance — I kept thinking , but what about medical care? Ha. Who could have seen this coming?

    Comment by SDHarms (f76bf1) — 2/21/2014 @ 4:32 pm

  24. She said she’s a second-class citizen.

    We’re all second-class citizens.

    Comment by AZ Bob (533fbc) — 2/21/2014 @ 8:46 pm

  25. Yet…
    =====

    You appear to have missed the bolding, the italics, the double underlines, AND the chomping-at-the-bit anticipatory ellipses…

    Glad I could help….

    Comment by Smock Puppet, "Si tacuisses, philosophus mansisses." (225d0d) — 2/22/2014 @ 12:54 am

  26. with ACA, they selected “none of the above”… 8-)

    Comment by redc1c4

    Well, that IS, after all, the government version: “The [Government] Rule of All Large Projects”.

    With a few random exceptions (Apollo is the only one I can think off the top of my head) that IS the SOP for large gummint projects.

    Comment by Smock Puppet, "Si tacuisses, philosophus mansisses." (225d0d) — 2/22/2014 @ 1:01 am

  27. …that IS the SOP for large gummint projects.

    i didn’t spend all that time on sci.military.naval for nothing.

    Comment by redc1c4 (abd49e) — 2/22/2014 @ 3:14 am

  28. illegitimi
    non carborundum I plead
    they will wear you out!

    Comment by Colonel Haiku (ec37e2) — 2/22/2014 @ 4:47 am

  29. Colonel, they should make a movie starring Matt Damon and call it Grinders.

    Comment by felipe (6100bc) — 2/22/2014 @ 6:15 am

  30. Matt… Daymun

    Comment by Colonel Haiku (ec37e2) — 2/22/2014 @ 6:19 am

  31. Affordable Care Act.

    It is not Affordable. There is little or no Care. But it is Act I in the continuing “transforming” of the nation into something none of us will recognize.

    Comment by navyvet (aca3d3) — 2/22/2014 @ 8:56 am

  32. #15
    hf- that was funny.
    except now under Obamacare and the Holder DOJ if ass cartilage gets wedged into too tight of a spot and detaches it could be both a pre-existing condition and a hate crime

    Comment by steveg (794291) — 2/22/2014 @ 10:37 am

  33. It sounds that if there is anything more ridiculous than ObamaCare, it is expecting that the “salad bowl of America” will spring back to life when global warming is stopped.

    I wonder If the President knows what is going to happen to the price of arugula? Actually, dumb question, I’m sure he doesn’t care, he’s the president and can get whatever he wants.

    Anybody remember the Beef shortage back in the early 70′s, and how some DC butcher made the headlines for refusing to sell steak to the Nixon WH for some state dinner?
    Yeah, back in the days when the President was not treated as Emperor.

    Comment by MD in Philly (f9371b) — 2/22/2014 @ 10:48 am

  34. I’ve been trying to get through to my insurance (Blue Shield) company to argue for coverage.
    The system makes me jump through a long series of voicemail hoops, the hoops that involve a spoken response like: “Say your date of birth..” so I do this as told and the stupid machine keeps confusing “sixty” with “fifty”. When I do get through to the next level I once waited on hold for over an hour only to hear a voice tell me that due to the volume of calls… and the robot b**** hung up on me.

    Under my new “better” policy:
    My Doctor is covered, the procedure he needs to do is approved and covered, but the surgery center he is contracted with is not covered. I am supposed to make the Doctor break his contract and use another surgery center.
    Granted he is probably part owner of the center he is contracted to, but this is not working for me.

    So in this case I like my Doctor and can keep him unless I need something beyond a check up… in which case I need to get another Doctor to do the brief outpatient procedure at an approved center.

    Thank you Mr. Obama for being the smartest President ever

    Comment by steveg (794291) — 2/22/2014 @ 10:54 am

  35. I’m so sorry, steveg, and it’s no consolation to know that you’re not alone in the problems you face. I hope you can somehow work it out.

    Comment by DRJ (a83b8b) — 2/22/2014 @ 11:11 am

  36. All pretense is dropped:

    http://www.bizpacreview.com/2014/02/22/obamacare-now-enrolling-inmates-to-boost-numbers-102299?

    Comment by gary gulrud (384f70) — 2/22/2014 @ 11:21 am

  37. i wasn’t aware there was ever a pretense…

    from my POV they started out at “fraud” and went south from there.

    Comment by redc1c4 (abd49e) — 2/22/2014 @ 11:50 am

  38. This blog post quotes all of a Wall Street Journal op-ed piece today. Also read the first comment.

    http://www.seraphicpress.com/the-cancer-that-is-obamacare/#more-20752

    The blog owner also compares this to the situation to what it was when it happened with his son, before Obamacare.

    I will just give two quotes.

    From the Op-ed piece:

    Because, however, the enrollment agents did not—unbelievable though this may seem—have access to the “coverage formularies” for the plans they were selling, they said the only way to find out in detail what was in the plan was to buy the plan. (Does that remind you of anyone?)

    With no other options, she bought the plan and was approved on Nov. 22….Then on Feb. 12, just before going into (yet another) surgery, she was informed by Humana that it would not, in fact, cover her Sandostatin, or other cancer-related medications. The cost of the Sandostatin alone, since Jan. 1, was $14,000, and the company was refusing to pay.

    From a comment:

    …I ventured out to the website to see what options I had and saw how bad the website design is. What disturbed me even more was that the focus was on the plan fianaces (premium, caps, and copays and not which doctors procedures and medications are covered which should be foremost in any proper insurance decision…I contacted directly two plans that are options in New Jersey- the first one; Blue Cross where the representative told me that if I have COBRA to use that Cobra and the rep from Amerihealth that I emailed said that the medication I need the most is not covered at all and will cost $15,000 a quarter.

    (the disease in that case is Multiple Sclerosis)

    Comment by Sammy Finkelman (6a010c) — 2/24/2014 @ 5:45 pm

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