Insurers Push Plans Limiting Patient Choice of Doctors and Hospitals

The inevitable reduction of physician/hospital choice begins as employers redistribute the cost burden of the Obama healthcare legislation to their employees.

Back in July of 2009, I predicted what effects the Obama healthcare legislation would have on a consumer/employees ability to choose their physician. Unfortunately, I was correct. The July 18, 2010 New York Times reveals that the country's biggest insurers are promoting plans with reduced premiums that require participants to use a narrower selection of doctors or hospitals.

The trade off, they say, for these reduced price plans, is that more Americans will be asked to pay higher prices for the privilege of choosing or keeping their own doctors if they are outside the new networks. Surprise! Remember the repeated assurances from Obama that consumers would retain a variety of healthcare choices?

But choice - or at least choice that will not cost you dearly - is likely to be increasingly scarce as health insurers and employers scramble to find ways of keeping premiums from becoming unaffordable. Aetna, Cigna, United and WellPoint are all trying out plans with more limited networks.

The size of these networks is typically much smaller than traditional plans. 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 network, but seeing physicians and hospitals outside the network will pay much more for the privilege.

With families paying an average of $13,000 annually for medical coverage, it is quite possible that with co-pays and deductibles, the premium penalty for choosing a top-tier physician and hospital might actually begin to eclipse that package rates of the identical procedure performed in India.

The choice will then between a local US physician/hospital whose medical outcomes are impossible to determine, versus a world renowned surgeon/super specialty hospital in India.