Our government has decided that it is okay for a doctor or hospital to charge an uninsured customer 10X what an insurance company would pay for a service. Thus, an American who doesn’t want to pay 10X the fair price and risk bankruptcy has no choice but to sign up for health insurance. He/she/ze/they cannot pay the $25,000 that an insurance company would pay for a serious issue and defer the purchase of a new car. Instead, he/she/ze/they must deal with a bill for $200,000 and aggressive bill collectors and lawyers from the hospital.
I recently decided to see if it would make sense to get a policy from healthcare.gov for our family. There are three big providers in eastern Florida: Mayo Clinic, Cleveland Clinic, and University of Miami. The site has a way to enter these providers and see if they’re in the network for the plan. Here are some of the quotes:
The consumer is supposed to evaluate 174 alternatives, build a spreadsheet and run a Monte Carlo experiment to figure out which is likely to result in minimum spending? You’d be a fool to have insurance that didn’t cover these three networks, as we discovered to our chagrin last year with Humana. Healthcare.gov offers to help you register to vote, but it doesn’t offer to limit results to insurance policies that will pay these essential providers.
I thought that Blue Cross had deals with everyone and yet this $66,000+/year policy ($72,000 including the out-of-pocket maximum) is presented as not covering any of the places that you’d want to go if you needed a specialized specialist:
Perhaps we could work it from the other side? Here’s what Mayo Jacksonville says they’ll take:
The consumer is supposed to recognize, therefore, that Mayo takes “Aetna” and “Blue Cross Blue Shield” but not the versions of “Aetna” and “Blue Cross” that are sold on healthcare.gov? How many people are this sophisticated? Mayo Jacksonville takes “Cigna EPO”, but, according to healthcare.gov, not “Cigna Connect 900 EPO”:
As Obama said, if you like your doctor you can keep your doctor so long as your doctor doesn’t work at any of the good clinics or hospitals in the nation’s third largest state. I scrolled through all of the 174 plans and never found one that covered more than University of Miami (and that was rare).
Maybe this is peculiar to Florida? Friends in Maskachusetts who had been paying $30,000 per year to Blue Cross (in pre-Biden dollars) switched to MassHealth (Medicaid; there was an income test, but no asset test on the MA signup web site) and found that their choice of doctors was much wider. That seems to be the case in Florida as well. Mayo Clinic is happy to accept Medicaid. Cleveland Clinic says they take Medicaid. University of Miami takes Medicaid. In other words, Americans have voted to set up a system in which a person who works and pays $72,000 per year for health insurance has inferior access to health care compared to what someone who has never worked enjoys.