We Americans like choices. Go to any large grocery store and stand in awe at the vast array of cereals: everything from regular old oatmeal to some sort of toasted rainbow sprinkles of joy. The market economy is built upon choice: not only does the consumer have a choice in what she wants, she can stay away from things she doesn’t want, like bad service or poorly prepared food. Yes, we like choices.
Obamacare is built on fewer choices, however. The New York Times tells us that we are facing fewer choices for our health care, fewer doctors and high costs if we wish to go outside of our prescribed network. Reed Abelson:
No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans.
Don’t like the idea of fewer choices for something so important as health care? Tough.
We have to break people away from the choice habit that everyone has,” said Marcus Merz, the chief executive of PreferredOne, an insurer in Golden Valley, Minn., that is owned by two health systems and a physician group. “We’re all trying to break away from this fixation on open access and broad networks.”
Some argue that large networks cost consumers more, while others say that Obamacare is forcing unwanted choices on consumers. Even that bastion of support for all things liberal, Mother Jones, says this problem of fewer choices is going to be tough.
Imagine what’s going to happen when millions of newly insured people, not savvy about how to police health care costs, start to get bills that far exceed what CoveredCA or healthcare.gov promised them? “My Obamacare policy cost me $800 for a blood test” is the next headline.
I think progressives need to start talking about this because it should be addressed by our side, not just to avoid mid-term election embarrassment, but because poor folks can be harmed by it. Hand waving this away as “we got poor people insurance, our job is done” is a mistake.
Marcus Merz, the chief executive of PreferredOne, an insurer in Golden Valley, Minn., says we need to stop being “fixated” on consumer choice, “open access and broad networks.” To me, this sounds a lot like Henry Ford telling us we can have a car in any color we want, so long as its black. A study from Standford Business School suggests that more consumer choices means better quality. This makes sense: in a free market economy, businesses have to compete. That means the restaurant with terrible waiters and awful food won’t last long if it’s surrounded by superior restaurants. However, if the horrible restaurant is the only choice, some people will go there; it’s the only choice for them. “Sure, it’s awful,” they might say, “but what are ya gonna do?”
We tried restricting health care choice 20 years ago, and it failed. Some folks remain undeterred:
Insurers insist these efforts will not run into the same resistance because they are now working more closely with providers, and customers are more concerned about costs. “It’s a new era,” said Dr. Sam Ho, the chief medical officer for United Healthcare.
Others agree. “You’re going to see this as a dominant strategy,” said Jeff Hoffman, who works closely with hospitals for Kurt Salmon, a consulting firm.
Mike Kreidler, an insurer in the state of Washington, says he wants to make sure that “carriers are not in a race to the bottom.” Fewer choices almost guarantee this.
Read “More Insured, but the Choices Are Narrowing” at The New York Times.
