The refusal to implement effective cost controls on medical care will continue to impact consumers, lulled into complacency through the “magical” concept of the Affordable Care Act. While the Affordable Care Act currently does not add up absent additional and continued legislation (in spite of President Clinton’s remarks about arithmetic), insurance companies are already considering new possibilities for limiting coverage to save their bottom line.
Insurance company support of Health Savings Accounts should have been an eye-opener to people when it was repackaged. Formerly a less than advantageous form of coverage for those who could get nothing else, then a means of protecting several thousand dollars a year from taxation for the wealthy, and finally being marketed as mainstream when more and more people could not obtain better health insurance coverage. Now that this inferior form of insurance coverage has gone mainstream, insurance companies are looking for more ways to sustain their bottom lines.
You know those tiered drugs? Get ready for tiered providers. Insurance companies are considering provided tiered coverage for providers in their networks, much like the tiered drug plans used today. You’ll pay more for using providers in specific tiers.
Get ready to pay more if you choose an out-of-network provider. Tightening the reins on any coverage at all for use of an out-of-network provider promises to both slow down patient ability to obtain care and reduce the choice of care individuals have who expect to be able to have any benefit from paying their premiums for coverage in the event they’re ill. This will greatly reduce the value of a PPO as compared to HMOs and we are likely to see a resurgence in HMO plans that typically provide no coverage if you use an out-of-network provider, but are currently cheaper than PPOs.
Reducing the number of providers offered is another insurance proposal being considered in some places in the industry. Consider fewer choices of providers for needed medical care.
While it’s frustrating that the Affordable Care Act’s emphasis on preventive services dazzled us into forgetting that health insurance’s primary purpose is to contribute towards payment for needed medical care. The Affordable Care Act has only begun to impact our medical options. Stay alert to the fact that needed medical care, for illness, is likely to become less available and more expensive in order to help insurance companies maintain their profits and the healthcare industry retain their right to charge whatever the market or the individual can bear.
Don’t simply wait and see what happens, consider alternatives like supporting the expansion of Medicaid in your state, or supporting legislation that will help consumers obtain and pay for needed healthcare when they are ill.
