11/12/2013    Al Musella, DPM

This Obamacare Problem Hasn't Surfaced Yet

I am surprised that I have not seen this in the
media..and there has been no public outcry yet.
See: http://www.medscape.com/viewarticle/813318

Many insurance companies are using the affordable
care act as an excuse to implement a truly
horrifying scenario: they are slashing their panel
of doctors - getting rid of the most "expensive"
ones and leaving the cheaper ones on the panel.

With the influx of patients getting insurance,
there will already be a shortage of doctors.
However, this is going to create a situation where
some doctors can not get on the panels - so they
will not be able to continue to treat their
patients or get other patients to replace them,
the doctors on the panels will be getting too busy
to treat patients correctly. Most of the new
ObamaCare plans have these panels - how can you
vastly increase the number of patients on an
insurance plan and at the same time slash the
number of doctors on the panel? A recipe for
disaster.

Patients with serious problems can forget about
getting the care they need under their so called
insurance.. The doctors who are deemed "expensive"
won't be on their plans, leaving them with the
"inexpensive" doctors. The difference is which
doctors treat the sickest patients who need
expensive tests and procedures. Doctors will be
encouraged to avoid needed tests if they are
expensive and sick patients will have a hard time
getting what they need.

The solution is pretty simple: get rid of provider
networks. Patient should be allowed to see
whichever doctors they want. Publish a fee
schedule for each plan, and that fee gets paid to
the provider, so it won't even cost the insurance
company any extra. Then publish a database of
providers who are willing to accept that fee as
full payment. The other doctors can charge the
usual fees but at least part of that will be
reimbursed. The patients can choose to pay extra
or not.

Al Musella, DPM, Hewlett, NY, Musella@aol.com

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