12.11.13

IF YOU LIKE YOUR HEALTH CARE PLAN, YOU CAN KEEP IT(*).

That statement has been parsed, and scrapped over, all over the blogosphere since the rollout of the federal health care exchanges.

The most sensible attempt at clarifying the fine print might have been by longtime Brookings analyst Henry Aaron.
To see why, imagine a new law enacted to promote food purity. As it is being debated, you are told: “If you like what you eat, you can keep on eating it.” The new law takes effect, and one day, you find that the market no longer carries certain foods you have been buying. As it happens, those products included elements found to be bad for your health. The pure food act barred their use.

Obamacare is analogous to the pure food law. It bars certain common practices of insurance companies that most people find unacceptable at best, outrageous at worst.
Those practices, including differential pricing for males and females, for people with pre-existing conditions, and for people of different ages might be logical, despite the logic being harsh, and as such those practices are qualitatively different from passing adulterated food off as nutritious.

Tyler Cowen raises a number of other questions, contemplation of which will reward careful study.  In part, the exchanges, and the government-approved insurance policies that subscribers have been able to buy, often interfere with existing relationships between provider and patient, particularly where specialists are concerned.  There has to be a way to end the rigidities of in-network or out-of-network reimbursement, no matter what the insurance contracts are.
How many of these people know that their new policies (if and when they can get them) will cover the same providers?  How can these people find out that information — now — in an easily verified manner?  And if they have to switch providers, how long will it take before their previous treatments are back up and running at an acceptable level?  What kind of publicly available information is available on this question?  Might their current providers start neglecting them, even before coverage is up, figuring they are “out the door” in any case?
It's trouble enough identifying a new physician or dentist in a new town, or when the existing people retire. Having to shop for a new one because the insurance coverage changes means unnecessary trouble. Having to shop for a new one because the insurer is behaving like a monopsonist means unnecessary trouble.

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