Obamacare generates profits for the federal government by blocking Americans’ ability to get high-quality advice or services from outside their local area, according to health care experts.
The Obamacare-compliant health benefit plans usually only pay for services within each citizen’s local region, said Dr. Scott Gottlieb, a former government health care official and an expert at the American Enterprise Institute.
Throughout 2014, the small regions will help regulators and executives narrow the variety, quality, number and cost of medical services available to at least three million Americans who already had plans on the individual market and are now being forced into Obamacare.
“They’re very narrow plans, they’re a throwback to the 1980s-style HMOs,” Gottlieb said.
“The majority of plans do not offer care beyond their regions,” said Yevgeniy Feyman, an expert at the New York-based Manhattan Institute.
“What this effectively does is limit the quality of care that some people are able to get,” Feynman said. “The more rural you get, the worse it is going to be,” he added.
In addition, within each region, the regulators and insurance companies seem to be steering enrollees to cheaper local hospitals, he said. In Philadelphia, Pa., for example, the Obamacare plans direct patients to Temple University Hospital, rather than to the higher-rated Hospital of the University of Pennsylvania, he said.
So if sick Americans want to get a second opinion from a specialist doctor in a neighboring county, or want to use get high-quality treatment at far-off specialized cancer or heart center across the state line, they’ll have to pay with extra cash after they’ve paid their mandatory Obamacare premiums, deductibles and co-pays, Gottlieb told The Daily Caller.
“Your out-of-pocket expenses could be 80 percent, 90 percent [of charges]….and there’s no cap on it,” he said.
“This is low-quality insurance… there is no other way to explain it,” Gottlieb told TheDC.
The policy is exemplified by Edie Sundby, who lives in San Diego, Calif.
Under her pre-Obamacare policy, she has been able to fend off lethal gallbladder cancer for almost seven years with the aid of doctors in University of California San Diego, specialists in Stanford University’s Cancer Institute, just south of San Francisco, plus the experts at M.D. Anderson, a famous anti-cancer center in Houston, Texas.
In addition, her insurance company, United Healthcare, is withdrawing from the state. Regulators only approved 13 of 33 companies who applied to offer services within one or more of California’s 13 regions.
“Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team,” she wrote in a Nov. 3 Wall Street Journal article.
But under Obamacare, “if I go with a health-exchange plan, I must choose between Stanford and UCSD,” without any insured access to the Texas center, she wrote.
California’s population of 38 million people are divided among 19 regions, with an average of 2 million people each. Some regions in the state contain more advanced hospitals that others, creating circumstance where people from the state’s agricultural sector may have little access to high-end centers without paying out of their pockets.
Several other states have even smaller regions.
Florida’s 19 million people are divided into 67 regions, with fewer than 400,000 people each, on average.
Colorado’s 11 regions contain an average of 200,000 people, and Georgia’s 16 regions contain an average of 600,000 people. Ohio’s 17 regions contain an average of 700,000 people, and Virginia’s 12 regions hold roughly 600,000 each.
Some networks, notably Blue Cross, are large enough to allow their customers get care in multiple regions, said Feyman. But other regions are stuck with a monopoly supplier that could reduce the quality care, he said.
“For a cancer patient, medical coverage is a matter of life and death,” Sundby wrote.
“Take away people’s ability to control their medical-coverage choices and they may die. I guess that’s a highly effective way to control medical costs,” she wrote.
“Perhaps that’s the point,” she concluded.
On Nov. 6, Obama flew down to Texas to champion his network, which has been stalled by crippled software.
“All of you understand that there’s no state that actually needs this more than Texas,” Obama told his supporters, who are trying to persuade the state’s fast-growing population of low-wage, Democratic-leaning Latino immigrants and youths to sign up for subsidized services.
“Here in just the Dallas area, 133,000 people who don’t currently have health insurance would immediately get health insurance,” he said. “There’s over $500 million just for this county that would come in” via WashingtonD.C., he said.
The Obamacare network “is pretty good” for the roughly 30 million Americans who lack insurance now, said Gottlieb.
But it’s no good for people with insurance, he added. The vast majority, he added, “are going to be be very disappointed.”