Doctors refuse to treat Obamacare patients, say they can’t afford to
As the rubber meets the road for the Affordable Care Act (ACA), many doctors are realizing that the healthcare overhaul simply won’t work for them if they want to actually stay in business. Many private practices, according to reports, are coming to the harsh realization that Obamacare’s reimbursement rates for medical care are dismal, which is why many doctors are choosing to opt out of the program entirely.
It is something that we predicted from the beginning — a very limited network of covered providers that are willing and able to accept lower-than-standard reimbursements. Obamacare’s most avid supporters were vehement in their denial that such a scenario would ever occur, but it is now clear that government-mandated coverage is unsustainable, and that quality of care will decline if doctors are forced to provide coverage at lower rates.
“I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,” stated Dr. Doug Gerard, a Connecticut-based internist, to NPR. “You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.”
While a normal private insurer would reimburse him about $100 for a standard patient visit, Dr. Gerard says Obamacare’s private insurance plans will only reimburse him about $80, which is roughly equivalent to the Medicare reimbursement rate. Among the three plans available on Connecticut’s Obamacare marketplace, only one of them meets the minimal reimbursement requirements that Dr. Gerard says are necessary for him to provide adequate care.
“I don’t think most physicians know what they’re being reimbursed,” he told NPR. “Only when they start seeing some of those rates come through will they realize how low the rates are they agreed to.”
Obamacare doesn’t even cover cancer treatment in many states
All of this may come as a shock to some who naively assumed that Obamacare would provide equal or greater coverage than true private insurance, but for less money. To quote the words of Connecticut State Medical Society President-elect Bob Russo, who recently spoke to The Daily Caller, “You get what you pay for.”
Nothing in life is free, of course — especially healthcare coverage. Despite the “Obama gon’ pay my mortgage!” sentiment expressed by some who obviously fail in their understanding of simple economics, somebody has to pay for all these added insurance holders who are unable to pay for themselves. In this case, that entity is the federal government via tax dollars, but at a predictably lower rate.
In some cases, even what types of conditions are covered under Obamacare is uncertain. According to The Daily Caller, top-tier hospitals that typically have multiple streams of reimbursement income, including those that treat severe conditions like cancer, are having to reject Obamacare plans, because they simply don’t cover enough of the treatment costs.
“I think it could lead potentially to this kind of distinction that there [are] these different tiers of quality of care,” added Kevin Counihan, the man in charge of Connecticut’s Obamacare marketplace, to NPR about the dilemma.
“The [perception that there are] different tiers of quality of care means somehow that the people think that just because my income is below 400 percent of the federal poverty level, I’m going to get inadequate care or lesser care than someone making above 400 percent.”
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