Are Americans Better Off Being Denied Access to the Best Hospitals?

 

By Jennifer Popik, JD, Robert Powell Center for Medical Ethics

ObamaneedlesThere is widespread evidence that many new Obamacare health insurance plans are reducing access to specialists and the best hospitals–most recently in California.

Obamacare apologist Jonathan Cohn–in an attempt to persuade the general public to embrace new healthcare reductions–makes the case that restricting access to expensive hospitals might be a good thing, focusing on Cedars-Sinai, a well-regarded Los Angeles-area hospital..

In a January 6, 2014, article in the New Republic, “If You Can’t Go to Cedars-Sinai Anymore, Is It Obamacare’s Fault? Consumer choices, cachet, and health care reform,” Cohn wrote

“The new plans generally provide more comprehensive benefits than the ones insurers sold before. And they are available to everybody, even people with preexisting medical conditions. But those upgrades cost money. To keep prices down, insurers are sending patients only to the doctors, clinics, and hospitals that have agreed to accept lower reimbursements.

“Anthem Blue Cross and Blue Shield of California, two of the state’s largest insurers, wanted bigger discounts than Cedars was willing to give, however. As a result, patients who want fully covered access to Cedars have only one option left: a health maintenance organization, called Health Net, with a relatively small network of doctors.

“The truth is that hospital quality varies a lot, depending on the severity and type of case. But that’s precisely the point. Nobody would question that Cedars is a strong hospital overall and that it produces some truly excellent results. According to official government data, the readmission rate for heart failure and pneumonia patients is well below both the national average and the rates at other area teaching hospitals. But that doesn’t mean Cedars is the place to go when you have a routine broken arm. A lowly community hospital might be just as good or better—and it will cost a lot less.”

The reality is that it is precisely when you are the sickest that you will need the best centers and specialists. Sure, Obamacare plans will do when you are well or have minor problems (issues of the cost of the plan and premiums aside), but it has been shown over and over again that these specialty centers, while more expensive, do best at treating major problems like cancer, heart failure, and so on. And now, thousands will no longer have access to those hospitals.

While Obamacare continues to roll out, it is important to continue to educate friends and neighbors about the dangers the law governing them poses in restricting what Americans can spend to save our own lives and the lives of our family members.

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