ObamaCare Health Plans to Limit Choices
In New York, for example, Aetna offers a narrow-network plan that has about half the doctors and two-thirds of the hospitals the insurer typically offers. People enrolled in this plan are covered only if they go to a doctor or hospital within the network.
In order to negotiate better rates, insurers need the ability to deprive some providers of enrollees’ business, while rewarding doctors and hospitals that negotiate favorable terms with additional business. This is how pharmacy benefit management companies negotiate with drug makers. If there are, say, four common drugs in a given class, the firm that submits the lowest bid is guaranteed 85% of the drug plan’s business (for that drug class) while the makers of the losing three drugs must split the remaining 15% of the business. Unless insurers have the ability to withhold (or reward) a provider of business, there will never be an incentive to negotiate.
Most people don’t travel that much. It seems that for most ailments, visiting a doctor in network isn’t a big deal. I don’t see that there are any huge problems with it. A one-size-fits-all, visit-any-doctor-you-want plan probably costs more than its worth.
This is where I always thought we were headed. I’m surprised to see it happen so quickly.