Another Obamacare problem: Not all the people in the operating room are going to be covered by your policy

Obamacare error 404The Marin Independent Journal is something of a joke as an investigative paper.  People in Marin read it, not to get  high-end analyses about news and policy, but, as is true for all small community  newspapers, to find out what’s going on in their neighborhood.  Sometimes, though, what’s going on in the neighborhood is a sufficiently important issue that it deserves to be broadcast widely.  It is to the IJ‘s credit that it’s bringing to its readers’ attention yet another problem with Obamacare, and not one I’ve heard discussed elsewhere; namely, the fact that, when you go in for surgery, even if your doctor is on your insurance plan, the anesthesiologist, whom most people first meet only within a couple of hours of surgery, may not be.

The IJ’s report starts with the story of Marianne Michael, a local Marin woman preparing for back surgery.  More savvy than many medical consumers, Michael knew that the anesthesiologist wasn’t actually part of her surgeon’s practice group, and that she would receive a separate bill.  Before surgery, therefore, she decided to do a little investigation to find out if her insurance would pay her the anesthesiologist:

Much to her surprise, Michael discovered that Anesthesiology Consultants of Marin was not in her network. Michael has also attempted to determine whether other medical groups serving Marin General are covered by her insurance, without much success.

[snip]

Michael said information on Anthem Blue Cross’s website indicated that the Marin Hospitalists Medical Group was also outside Blue Cross’ network of providers for Covered California customers.

[snip]

The dawning of Obamacare has resulted in confusion over which medical groups supplying ancillary services to the hospitals — anesthesiologists, radiologists, pathologists and hospitalists — have contracted with Blue Shield and Anthem Blue Cross to serve their new Affordable Care Act customers. The insured with these plans must pay substantially more for any service provided by a doctor outside their insurer’s network of providers.

Once the confusion is lifted, it’s clear that Obamacare’s newest customers are screwed (emphasis added):

In fact, Blue Shield’s exclusive provider organization (EPO) customers in Marin must pay 100 percent of the cost for out-of-network services.

To recap:  People in Marin, like most previously insured Americans, are accustomed to the fact that, if they’re insured and if they have surgery, their insurance pays for it all:  surgery, hospital, and anesthesiologist (subject to whatever deductible they owe).  In the new regime, though, they’ll be lucky if their policy pays for the surgeon and hospital.  In addition to the deductible (usually higher under Obamacare than before), they’ll find themselves out-of-pocket, often to the tune of tens of thousands of dollars, for the anesthesiologist and other independent service providers affiliated with their surgery.  Surprise!!!

Moreover, thanks to Obamacare, this disastrous, expensive, stealth change isn’t limited just to new “Covered California” (i.e., Obamacare network) customers.  Instead, it applies to everyone, regardless of whether they purchased insurance in the remaining marketplace or through Obamacare:

It isn’t just people who purchased insurance through Covered California, the state’s health care insurance exchange, that stand to be affected by the coverage muddle. Under the Affordable Care Act, insurance companies were required to offer plans that mirror their Covered California plans. These plans have the same network of providers as the Covered California plans. Michael said she purchased her insurance directly from Anthem Blue Cross.

(One presumes that the sole exception to this is those lucky enough not to have been amongst the 160,000 people kicked off of California’s Kaiser network.  If you’re a Kaiser member, Kaiser offers everything in-house.)

Bad as the above is, according to the IJ, it doesn’t stop there but, instead, gets even worse for Californians (the vast majority of whom enthusiastically supported both Obama and Obamacare).  Thanks to an Anthem Blue Cross snafu, customers pursuing the list of networked doctors were misled to the tune of almost 1000 doctors who were erroneously identified as being part of the Anthem Blue Cross Obamacare-compliant network.  In other words, vast numbers of those who signed up with Anthem Blue Cross because they were trying to keep their doctor (and didn’t Obama promise that they could?), ended up with a policy that probably costs more; that almost certainly has a higher deductible; that, through fraud or negligent misrepresentation, doesn’t allow them to keep their doctor; and that doesn’t cover significant parts of their costs.

Obama was boasting about the 8 million who signed up.  He’s going to regret that boast, because it appears that America is soon going to have 8 million dissatisfied customers, not to mention the millions more who, even though they didn’t sign up, have been left with insurance contracts that, by law, must be just as bad as those offered under Obamacare.

One wonders how much longer Marinites and other Blue Californians can maintain the cognitive dissonance that tells them that Obama is the best president ever and that Obamacare has bent the cost curve down, bringing affordable, high quality health care to everyone.  On a daily basis, the reality of their own lives is proving that all of this is a lie.  Also, one wonders just how craven (stupid? corrupt? evil?) Congressional Republicans are when they say that Obamacare is here to stay, and that they are powerless to revert America’s health care back to a free market dynamic.

(And please don’t get me started on the House GOP’s promise to pass amnesty.  Just let me say that, if I had a Republican representative in the House, I would be on the phone to his office every single day letting him know in the strongest possible terms that I would do everything within my power in his district to destroy his political career and to make sure that, should he ever set foot in his district again, he couldn’t get a job as dog catcher, street cleaner, or McDonald’s clerk, all of which forms of employment are way too honorable for him.)

 

If this is accurate, it’s very revealing about Obamacare’s true goals

Obamacare error 404Earl forwarded me the following email, with the same caveat I’m giving you:  I do not know if the data is accurate — and I’m not going to check.  As with previous emails, I’m passing it along as is in regard to the facts.  Of course, should you investigate these facts, or have first-hand knowledge about them, I’d be delighted if you’d share your information with us.

What Obama-Care is Really About?!

I’m a 54 year old consulting engineer and make between $60,000 and $125,000 per year, depending on how hard I work and whether or not there are work projects out there for me.

My girlfriend is 61 and makes about $18,000 per year, working as a part-time mail clerk.

For me, making $60,000 a year, under Obama Care, the cheapest, lowest grade policy I can buy, which also happens to impose a $5,000 deductible, costs $482 per month.

For my girlfriend, the same exact policy, same deductible, costs $1 per month. That’s right, $1 per month. I’m not making this up.

Don’t believe me? Just go to www.coveredca.gov , the Obama Care website for California and enter the parameters I’ve mentioned above and see for yourself. By the way, my zip code is 93940. You’ll need to enter that.

So OK, clearly Obama Care is a scheme that involves putting the cost burden of healthcare onto the middle and upper-income wage earners. But there’s a lot more to it. Stick with me.

And before I make my next points, I’d like you to think about something:

I live in Monterey County, in Central California. We have a large land mass but just 426,000 residents – about the population of Colorado Springs or the city of Omaha.

But we do have a large Hispanic population, including a large number of illegal aliens, and to serve this group we have Natividad Medical Center, a massive, Federally subsidized county medical complex that takes up an area about one-third the size of the Chrysler Corporation automobile assembly plant in Belvedere, Illinois (see Google Earth View). Natividad has state-of-the-art operating rooms, Computer Tomography and Magnetic Resonance Imaging, fully equipped, 24 hour emergency room, and much more. If you have no insurance, if you’ve been in a drive-by shooting or have overdosed on crack cocaine, this is where you go. And it’s essentially free, because almost everyone who ends up in the ER is uninsured.

Last year, 2,735 babies were born at Natividad. 32% of these were born to out-of-wedlock teenage mothers, 93% of which were Hispanic. Less than 20% could demonstrate proof of citizenship, and 71% listed their native language as Spanish. Of these 876 births, only 40 were covered under [any kind of] private health insurance. The taxpayers paid for the other 836. And in case you were wondering about the entire population – all 2,735 births – less than 24% involved insured coverage or even partial payment on behalf of the patient to the hospital in exchange for services. Keep this in mind as we move forward.

Now consider this:

If I want to upgrade my policy to a low-deductible premium policy, such as what I had with my last employer, my cost is $886 per month. But my girlfriend can upgrade her policy to the very same level, for just $4 per month. That’s right, $4 per month. $48 per year for a zero-deductible, premium healthcare policy – the kind of thing you get when you work at IBM (except of course, IBM employees pay an average of $170 per month out of pocket for their coverage).

I mean, it’s bad enough that I will be forced to subsidize the Obama Care scheme in the first place. But even if I agreed with the basic scheme, which of course I do not, I would never agree to subsidize premium policies. If I have to pay $482 a month for a budget policy, I sure as hell do not want the guy I’m subsidizing to get a better policy, for less that 1% of what I have to fork out each month for a low-end policy.

Why must I pay $482 per month for something the other guy gets for a dollar? And why should the other guy get to buy an $886 policy for $4 a month? Think about this: I have to pay $10,632 a year for the same thing that the other guy can get for $48. $10,000 of net income is 60 days of full time work as an engineer. $48 is something I could pay for collecting aluminum cans and plastic bottles, one day a month.

Are you with me on this? Are you starting to get an idea what Obama-Care is really about?

Obama Care is not about dealing with inequities in the healthcare system. That’s just the cover story. The real story is that it is a massive, political power grab. Do you think anyone who can insure himself with a premium policy for $4 a month will vote for anyone but the political party that provides him such a deal? Obama Care is about enabling, subsidizing, and expanding the Left’s political power base, at taxpayer expense. Why would I vote for anyone but a Democrat if I can have babies for $4 a month? For that matter, why would I go to college or strive for a better job or income if it means I have to pay real money for healthcare coverage? Heck, why study engineering when I can be a schlep for $20K per year and buy a new F-150 with all the money I’m saving?

And think about those $4-a-month babies – think in terms of propagation models. Think of just how many babies will be born to irresponsible, under-educated mothers. Will we get a new crop of brain surgeons and particle physicists from the dollar baby club, or will we need more cops, criminal courts and prisons? One thing you can be certain of: At $4 a month, they’ll multiply, and multiply, and multiply. And not one of them will vote Republican.

Obama-Care: It’s all about political power.

Now, do you see where we are going?

I’m getting the feeling that a lot of people are signed up for health care, but haven’t yet paid

kaiser_permanente_logoI’m fortunate (for at least one more year) because we get our Kaiser health insurance through my husband’s employer.  I like Kaiser and can highly recommend it for those of you who are searching for new insurance options in Norther California.

But I’m not writing this to shill for Kaiser.  Instead, I’d like to relay to you the important notice it has on its website:

If you enrolled in a Kaiser Permanente health plan through the Health Insurance Marketplace, thank you for choosing us as your partner in health.

If you applied for a January 1 effective date, you should receive a bill for your first month’s payment in the mail by January 11, if you haven’t received it already. In order for your coverage to be effective as of January 1, 2014, you must pay your first month’s premium no later than January 15, 2014.

Once you receive your bill, you can pay your premium online at kp.org/paypremium or by mail. (If by mail, payment must be postmarked on or before January 15, 2014.)

If you don’t receive your bill by January 11, 2014, please call us at 1-800-759-0584.

We look forward to a long and healthy relationship with you.

Welcome to Kaiser Permanente.

When I read that, it occurs to me that many have chosen, but few have paid.  Or maybe I’m just letting suspicion about the administration’s veracity when it reports sign-up numbers color my perceptions.

Found it on Facebook: Young California man automatically enrolled in Medi-Cal

Covered CaliforniaBecause California’s “Covered California” exchange seemed to get off to a good(ish) start, my Leftist friends on Facebook have been boasting that it proves that, if more states had agreed to have their own exchanges, the federal Obamacare exchange would have been a non-issue.  To which I now say “Not so fast, oh Leftist friends.”

Another one of my Facebook friends is a classic independent:  he’s a young man in his mid-20s, quite brilliant, with a computer degree from a top (way top) school.  Unsurprisingly, despite his youth, he has a very good job with an even better income.  That’s why I accept as absolute truth the message that this young man posted on his Facebook page.  (I’ve edited the message slightly, so as to protect his privacy.  The content is unchanged, but some of the vocabulary is different.)

I opened my mail today and discovered I’d been enrolled into Medi-Cal. I never applied for Medi-Cal, since I have an income and I have health insurance through a private insurance company.  The only thing that I did was to sign up for California’s exchange [Covered California].  I just wanted to compare prices, so I never completed an application.  Worse, now that I’m “on Medi-Cal,” I don’t know what to do to get off again.

This is your tax dollars at work.