The Rise of ObamaCare's 'Surprise Medical Bills'


As recently as 2013, President Barack Obama was still boasting that his signature legislative “accomplishment” made the cost of healthcare “fully transparent.” During a speech he gave at Prince George’s Community College in Largo Maryland, Obama said:


So you enter in some basic information about yourself, what level of coverage you’re looking for.  After that, you’ll be presented with a list of quality, affordable plans that are available in your area.  It will say clearly what each plan covers, what each plan costs. The price will be right there. It will be fully transparent. …

And keep in mind the government didn’t set these prices. The insurance companies — they proposed these prices because they want to get in with these big groups, with all these new customers.  The insurance companies are saying these marketplaces, this law, will work. They’re putting money on the line because they think it will work.  Competition, choice, transparency — all these things are keeping costs down.

That wasn’t true in 2013 and it’s not true today.

As a recent article in TIME shows, so-called “surprise medical bills” are becoming a thing. “An estimated 1 in 3 American adults with private health insurance falls victim every two years to what are known, aptly, as ‘surprise medical bills,’ according to a 2015 survey by Consumer Reports. Such bills arise when an in-network medical facility contracts with out-of-network medical staff, including emergency-room doctors, anesthesiologists, surgical assistants or lab technicians.”


Essentially, the problem is this. Insurance companies will only cover in-network healthcare providers. If your hospital and doctors are covered in your insurance carrier’s network, you’re fine. The deal as you understand it works: you pay the premiums and cover the deductible and the insurance company them does its part. But what if the anesthetist down the hall or the X-Ray tech two floors up is not covered in your carrier’s network? Well, no one tells you. And a little while later surprise, you get thousands of dollars in medical bills your insurance company won’t pay.

The Time article talks about “invisible lines” in hospitals separating providers who are in a network and those who aren’t. Perhaps these invisible lines reflect the transparency Obama promised.

The chief culprit is the insurance companies that have narrowed their provider networks under ObamaCare. As the Time article states:

Efforts to fix the problem through legislation have been halting, largely because the issue pits three powerful players in the health care industry–hospitals, physicians’ groups and insurance companies–against one another. Those groups all know that any new law shielding patients from surprise bills would require one of them to eat those costs instead. Steven Stack, the president of the American Medical Association, which represents physicians, puts the onus on insurance companies to include more hospital-based physicians in their networks. Tom Nickels, an executive vice president of the American Hospital Association, takes a similar tack, arguing that it’s insurance companies’ responsibility to tell patients which providers are covered. In recent years, patient groups have sued Anthem and rival Blue Shield of California on the grounds that the companies were not transparent about which providers were in network.


Don’t expect any positive changes, though. The insurance companies have powerful friends, as Stephen DeMaura of Americans for Job Security points out in a recent Op-Ed. DeMaura observes, Insurance executives are implementing ObamaCare and revolving door between Obama’s administration and the health insurers is cronyism at its worst:

A facet of the current healthcare landscape that is perhaps putting consumers at the greatest disadvantage is the government’s ever cozier relationship with the insurance industry—a partnership that is only increasing healthcare costs as insurance companies find themselves on the receiving end of more profits.

[. . .]With the government and insurance industry clearly working hand in hand, it is not surprising that insurance companies are finding themselves on the receiving end of the law. While premiums have doubled, insurers have reaped in millions in stocks and earnings—profiteering at the expense of those who need good healthcare policies the most: patients and the businesses who employ them. Profits are good, when earned. But remember, ObamaCare mandates the purchase of these products, whether the customer wants them or not.

Unfortunately, the insurance companies are politically protected because of all their deep connections to Obama’s administration. Don’t expect ObamaCare’s “surprise medical bills” to be fixed until the ObamaCrats are removed.



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