OUT: You can keep your doctor, period.
National insurance giant UnitedHealthcare plans to cut up to 700 Massachusetts doctors from its physician network for seniors enrolled in its private Medicare plan as a way to control costs, according to company officials.
For elderly patients enrolled in the plan, the cuts mean they will have to find a new doctor or eventually switch to a new health plan that covers their current doctor.
UnitedHealthcare is the country’s largest provider of privately managed Medicare Advantage plans, and the ongoing cuts have prompted lawsuits by doctors, state investigations, and recent federal policy changes to better protect consumers. There is also pending legislation in Congress to prevent health plans from cutting physicians mid-year.
“This phenomenon is nationwide and needs to be addressed,” Senator Richard Blumenthal, a Connecticut Democrat, said in an interview. “I’m reviewing possible legislation that would prevent this kind of draconian discharge of providers from networks serving Medicare Advantage patients.”
The changes come amid a gradual reduction of reimbursements to private insurers that offer Medicare Advantage plans as a way to offset costs associated with President Obama’s health reform law.
Right. If we had an independent press, instead of a gang of cheerleaders, we would have known this was coming. It’s the law of the land—what’s more, it’s Constitutional, bitches.
UnitedHealthcare officials say they hope that streamlining the pool of doctors will not just save money but ultimately improve the quality of patient care — and thus improve its chances of receiving bonus payments under a new federal rating system.
Cost savings could translate into more affordable care for patients, the insurer said, with the potential for lower out-of-pocket costs for prescription and office visit co-pays.
“Network restructuring is the new normal. It’s not just UnitedHealthcare, but that’s the way health plans will be operating in the future,” said Dr. Sam Ho, UnitedHealthcare’s chief medical officer, in an interview. “Healthcare is going through so many significant changes that it’s no longer a matter of doctors providing services and health plans paying claims, but a focus on the quality and cost effectiveness of those services.”
I think that’s nonsense, too, but what did people expect when Obama tipped over the health insurance apple cart?
A better metaphor:
“We’re really opposed to their actions because it’s going to limit access to care,” said Dr. Richard Pieters, president of the Massachusetts Medical Society. “We think the decisions on how they are eliminating physicians may well be arbitrary and not based on quality. It’s very unsettling. Potentially, this is just another domino starting to fall.”
Another domino. That’s it exactly. And Obama toppled the first one.
“A government big enough to give you everything you want, is a government big enough to take away everything that you have.”