Dr. Bihari Goes to Washington

Dr. Bihari Goes to Washington - Healthcare Reform, Unintended Consequences?

Tuesday June 29, 2010

Last week I shared our exciting news that Dr. Michael Bihari, About.com's Guide to Health Insurance, had been invited for a sit-down at the White House with HHS Secretary Kathleen Sebelius to ask questions about patients rights and healthcare reform, the Affordable Care Act (a title which doesn't seem to inflame people as much as 'healthcare reform' does.)
If you missed it -- you can watch the entire 12 minutes of the conversation -- which was really quite informative.  Dr. Mike has written a follow up, too in which he outlines the Secretary's answers to the questions About.com visitors had submitted ahead of time.
Among the many good answers Secy Sebelius provided, were two worth sharing here. Following her answers, I'll share a few concerns:
1.  Lifetime limits on health insurance coverage.  You probably have no idea if your current health insurance plan provides a limit over which it will no longer pay for your healthcare.  Most people don't have any idea until they reach that limit, until, after a horrible accident or a diagnosis of a debilitating disease, they are told that they have hit that ceiling and -- sorry -- their insurance has run out.
Run out?  Most never knew that was a possibility.  In particular, those people who have individual insurance that feel like they found some great deal on the monthly premiums -- until they find out the hard way that the limit is reached much quicker than they ever imagined.
However!  The Affordable Care Act has put the kibosh on that limit - plus the annual limit, too.  Like other aspects of the Act, none of that kicks in until September of this year.  Once you renew or choose a new healthplan for 2011, you'll no longer have to worry about those annual caps, nor a lifetime cap.
2.  Another of the big points, one which we heard President Obama repeat many times, is that you will be able to choose any doctor you want to, as long as that doctor accepts your insurance plan. "If you like your doctor, you can keep your doctor," the President reminded us, many times, as did Secretary Sebelius remind Dr. Mike.
So those are the two points I wanted to share from the conversation between Secy Sebelius and Dr. Mike...
Ahhh.... but sometimes we have to take a look at Newton's Laws of Healthcare Motion -- AKA -- "every action has an equal and opposite reaction," as they apply to healthcare reform.
When I am thinking with my purest heart, I am so happy to see that these concerns have been addressed.  Many of you, my blog readers, know that I supported Healthcare Reform as a concept.  I still do, and I am happy that we are at least on the road to a far fairer system than we have had to this point.
But my internal warning bells begin ringing on occasion, too.  Those potential unintended consequences continue to rear their ugly heads - and I worry.
1.  Not that I don't think it's a good idea from the patient-wallet point of view, but I worry that removing any potential caps from health plans will drive up everyone's premiums and other health insurance costs.  As it is, when we all learn what our insurance is going to cost beginning in 2011, we're all going to be upset!  Removing caps?  Somebody's going to pay.  We're going to share it.
2.  Yes - we will all have the opportunity to choose any doctors who are on our health plan.  But that's the key -- doctors who are on our health plan. Most of us have had the experience of learning that a doctor we liked and trusted is no longer accepting the insurance plan we have.  And I suspect that we will begin to see some major shifts in which doctors are accepting which plans when we begin getting our paperwork and choices for 2011 next Fall.  Health plans are going to cut their reimbursements to doctors, and that looming Medicare cut is due to be reviewed again come November.  Bottom line -- yes, to the letter of the law, we'll be able to choose any doctor who is on our health plan.  We just don't know which doctors will still be working with which health plans...
Which is why it will be more important than ever, come next Fall when you are asked to re-up on your health insurance plan, that you take some time to look on their doctor lists, or to phone your doctor's office, to be sure your doctors are included on the plan you hope to choose.
Thanks to Dr. Mike for his great preparation for his meeting with Secy Sebelius.  We'll keep our fingers crossed that he'll be invited again for another round of Q&A.
•  Read Dr. Mike's summary of his question and answer session about patients' rights and the Affordable Care Act with Secy. Sebelius
•  Read Dr. Mike's article about  healthcare reform and patient safety, too.