Last Friday's OC Register explains a disturbing new trend in health care:
A small but growing number of Orange County doctors has stopped accepting private insurance, saying they are fed up with low reimbursements that can take months to receive, lost claims and denials of necessary medical care.
This fall, Women's Medical Group of Irvine dropped roughly 20 preferred provider organizations after more and more staff time went to insurance paperwork rather than patients.
"We were spending inordinate amounts of time and resources on things that have nothing to do with the quality of patient care," said gynecologist Felice Gersh, medical director of the four-doctor practice. "I would be more than happy to be a member of all the health plans if they paid me reasonably and quickly."
For instance, Gersh received a letter in August from Nationwide Health Plans over a $110 charge for an office visit. The insurer refused to process the claim unless Gersh sent five years' worth of patient records including chart notes, pharmacy records and lab/X-ray results.
And if you don't have the cash? You're SOL.
As one of the nation's leading health care bloggers, nyceve, explained this morning, we're being set up for junk health care reform - reform in name only. She points out the same thing I have repeatedly been arguing, that the problem with health care in America isn't that people are uninsured, but that insurance is no guarantee of health care.
What these Orange County doctors are warning us is that the ABx1 1 approach will not necessarily accomplish anything. If it doesn't address the central problem of insurers denying claims and care, then doctors will simply stop accepting insurance and demand payment in cash, as this Irvine clinic has already done. Under the ABx1 1 plan, Californians would then be running a very high risk of purchasing junk insurance that they can't actually use anywhere.
We keep hearing that ABx1 1 would, despite it's flaws, be a step forward that would help we Californians who are uninsured. As I look at this, though, I don't see how ABx1 1 would do much at all to help me afford the health care coverage I currently don't have. The problem is affordability, not lack of insurance. |
