Health law’s ailments can be cured by single-payer system
The doctor can’t see you now. Consumers may hear that a lot more often after getting health insurance under President Obama ‘s Affordable Care Act . To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state’s new health insurance market opening Oct. 1. New data reveal the extent of those cuts in California, a crucial test bed for the federal healthcare law. These diminished medical networks are fueling growing concerns that many patients will still struggle to get care despite the nation’s biggest healthcare expansion in half a century.
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Health insurance sales hit the mall — and Web
Horizon Blue Cross Blue Shield senior retail agent Salima Matthews helps Robert Rossell of Southampton, N.J., with information pertaining to his wife’s medical benefits on Sept. 10. (Photo: Douglas Bovitt for USA TODAY) Story Highlights Clothes or catastrophic health coverage? Both are at the mall United Healthcare, Blue Cross Blue Shield stores leading the way Would you like some life insurance with that?
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That happened because the insurers didn’t hire enough staff to give the claims from those clinics decent scrutiny in other words, their administrative costs, high as they were, didn’t buy adequate oversight. The result, to cite just one example, was that United paid the chain more than $97,000 for a kidney stone operation that it usually covers for $6,851. “Private insurance is a parasite in the system,” says Arnold S. Relman, the former editor of the New England Journal of Medicine and an advocate of healthcare reform. “It adds nothing of value commensurate with its cost.” Relman believes that fixing the healthcare system will require more than single-payer. The delivery of care needs to be reorganized by promoting the formation of more “accountable care organizations” medium- and large-scale group practices with hospital affiliates whose physicians would be salaried to discourage the overuse fostered by the fee-for-service system. What’s really needed is political will.
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