ObamaCare Creating Two-Tier System

May 6, 2014

Americans most dependent on public insurance will have less and less access to medical care under ObamaCare, writes Scott Atlas, a physician and a senior fellow at the Hoover Institution.

Reimbursement rates for Medicare and Medicaid are already low, a fact that has led doctors to refuse to treat those patients. With reimbursements falling even further, more doctors will begin to refuse those with government insurance plans.

President Obama has touted the Affordable Care Act as increasing insurance choices, but this is not what those in the exchange are seeing.

  • Consumers in 16 states have the option of just three or fewer insurers, and the average number of plans offered in individual states has dropped from 117 in 2013 down to just 41 in the exchanges.
  • In order to meet the requirements of the law, the plans that insurers are offering are very restrictive and do not include some of the best hospitals in America. According to a study by McKinsey, 33 percent of individual insurance offerings contained narrow networks in 2010. This year, 68 percent of options have narrow networks.
  • The vast majority of the best cancer hospitals -- including MD Anderson Cancer Center in Houston and Seattle Children's Hospital -- are not included in most state exchange plans.

Patients who can afford it are signing up at concierge practices. Today, there are an estimated 4,400 concierge physicians -- 30 percent more than just last year. And according to a survey from Merritt Hawkins, 7 to 10 percent of doctors plan to move to concierge or cash-only practices within the next three years.

Europe has already experienced a two-tiered health care system.

  • Six million British citizens who can afford to do so purchase private insurance today, despite the fact that they already pay for the National Health Service.
  • More than 50,000 travel outside of the United Kingdom each year in order to receive treatment abroad -- spending more than $250 million in the process.
  • Sweden has seen similar trends, with 500,000 of its citizens now using private insurance.

The United States will see similar divisions if ObamaCare remains in place. Those who can afford private care will have access to it, while those dependent upon government systems will have fewer choices and less access to their doctors. 

Source: Scott W. Atlas, "The Coming Two-Tier Health System," Wall Street Journal, April 30, 2014.

 

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