One pill makes you larger, and one pill makes you small, and the ones that mother gives you don’t do anything at all. Go ask Alice – when she’s ten feet tall. So begins the song written by Grace Slick in 1965, and released in 1967 by the band Jefferson Airplane on their timeless album Surrealistic Pillow. This song is loaded with imagery form Lewis Carroll’s Alice’s Adventures in Wonderland and over the past couple of months I have personally experienced the Wonderland like adventure of being on Obamacare.
I normally don’t like to use derogatory terms, but in this case I can only be derogatory toward the Affordable Care Act. The experience that my company has undergone reflects on the truly insidious nature of this new health care regime, and shows that the Administration was completely untruthful about how the program would impact people. Not only have I (for one) not been able to keep my own doctors, but nearly all of my doctors have completely opted out of taking insurance all together. In addition, due to the failures of Obamacare, my company is not even able to offer its employees company sponsored insurance anymore. It is likely that almost no small firms in New York City can offer a plan since insurance companies simply are not writing them anymore.
The last plan that my firm could even get was offered by a firm called Health Republic. This was one of the 23 s CO-OPs, established under the Affordable Care Act to increase competition in the marketplace. Health Republic was the largest CO-OP in the country, but like over half of the CO-OPs set up under the law, Health Republic disappeared like the Cheshire Cat unceremoniously last November, making people, including those working in my office scramble to find coverage for December.
But this was not the end of the trip down the tunnel to Wonderland. With Health Republic gone, and most plans not offering any reasonable coverage for small groups, my entire office was thrown to the mercy of the Health Care Exchanges. Trying to negotiate one of these exchanges (or at least the one in New York) is like having a conversation with the Mad Hatter. When you try to seriously find a reasonable health care plan you are left with nothing but nonsense. The exchange was where I met the craziest character of Obamacare Wonderland, the micro-HMO. All of the plans on the exchange are HMO’s, and require that the insured use only the doctors in the plan network. In fact, as of this year in New York City, individuals can’t sign up for a PPO either on or off the exchange meaning that no out-of-network coverage exists outside of an employer plan, which by the way, no insurer will write for a small business.
The thing is that nearly all of these HMO plans have networks with only a very limited number of doctors, and as we have found out with the plan we selected, the number of doctors falls every day. In fact, I have been trying to find a doctor for a routine procedure for weeks, and it appears as if only a handful of physicians in New York City accept my plan at all. I have joked that it is easy to make money selling insurance. Offer it for only a hundred dollars a month, and ensure that only doctors with offices is Turkmenistan accept the plan. This is basically how all of these micro-HMOs work. My wife has had the same problem trying to find a specialist for a simple procedure. She spoke with a concierge at the insurance company and they set up an appointment for her (they of course did not tell her). When the office called to confirm the appointment, she discovered that it was a once-a-week Medicaid clinic, and oh – they did not accept the plan. In other words, dealing with the type of insurance offered under the Affordable Care Act is like trying to reason with the Queen of Hearts, the rules don’t make sense and are all designed to keep you from getting medical help. Simply put, the Affordable Care Act, which was supposed to move medicine from hospital emergency rooms to doctors’ offices, has move all covered medicine to – well hospital emergency rooms.
Even when doctors are on the micro-HMO they are swamped with patients since the law requires them to spend precious time running around like the While Rabbit himself, filling out on-line forms (the electronic medical records) rather than providing treatment and counsel.
Jonathan Gruber was right when he said that the wool was pulled over people’s eyes when Obamacare was passed. Sure more people have insurance, but the insurance does not cover anything. In addition, millions of people who once had private insurance or insurance through an employer are now on exchanges covered by a micro-HMO with no doctors. No wonder people feel like Alice, and are desperate to get out of Wonderland and back to the world where if they like their doctor they can keep their doctor.