You can't keep that either.
In 2013, the American people learned what whoppers the key promises
of ObamaCare turned out to be. But the biggest whopper about the
Affordable Care Act is yet to be exposed: the tightening grip the
federal government will have over your doctor — even if you’re paying
with private insurance.
More on this topic here.
Like so many other parts of ObamaCare, the reality flies in the face
of promises. In this case, it was the one where the president assured us
that “you’re not going to have anybody getting in between you and your
doctor in your decision making.”
Section 1311(h)(1)(B) of the health law gives the secretary of Health
and Human Services blanket authority to dictate how doctors treat
patients. Not just patients in government programs like Medicare and
Medicaid, but patients with private plans they pay for themselves. On
Dec. 2, 2013, we learned from the Federal Register that the rules are
now being written. Starting in 2015, insurance companies will be barred
from doing business with doctors who fail to comply. The rules will be
offered in the name of ensuring “health-care quality,” which of course
could mean anything.
“The powers given to the secretary are so broad, he or she could
literally dictate how all physicians nationwide practice medicine,”
warns Congressman Phil Gingrey (R. Georgia), himself a physician.
Gingrey is sponsoring a bill to repeal Section 1311(h)(1)(B). Otherwise,
he says, the HHS secretary — a Washington bureaucrat with no medical
training — could, for example, bar doctors from doing routine mammogram
screenings until female patients turn 50. In short, the federal
government will be calling the shots on what patients get.
More important, the analysis of costs alone
misses the central point. While Blue Shield is not charging a great deal
more than PacifiCare would have under their old plan, it is for a
vastly inferior product. As Mrs. Sundby wrote in her op-ed, she has
received care from three hospitals. Her primary oncologist is at
Stanford University's Cancer Institute. She got less specialized
treatment such as chemotherapy locally, at Moores Cancer Center, part of
the University of California, San Diego. She has also been treated at
the M.D. Anderson Cancer Center in Houston.
plan available in San Diego includes both UCSD and Stanford in its
network, so the Sundbys were forced to choose between them. The Blue
Shield plan covers care at Stanford, so that she will now have to get
local care elsewhere.
acknowledge in his penultimate paragraph that Mrs. Sundby "may need to
find a different health care provider. . . . If Sundby continues to see
the non-participating doctors, she will incur additional out-of-pocket
health care costs." That is, he treated as an afterthought the actual
injury ObamaCare inflicts on her. She was victimized twice by the
president's consumer fraud. She lost the plan she liked and doctors she liked.
didn't write about this in November because our conversation with the
Sundbys' broker left us confused. The broker believed that ObamaCare
plans would cover out-of-network treatments, with higher copayments but
the same limit on total out-of-pocket expenses. That called into
question the premise of Mrs. Sundby's op-ed: Had the broker been right,
Mrs. Sundby would have been able to get the same care at only somewhat
But the broker was
misinformed. Mrs. Sundby confirmed with an administrator at UCSD that
none of the plans that included Stanford in their networks would cover
the full cost of treatment at Moores. Mrs. Sundby told us that her new
plan covers out-of-network care only up to the (far lower) negotiated
fees for equivalent treatment within the network; the difference must be
paid out of pocket and does not count toward the annual limit on
That makes the cost of care at UCSD prohibitive and forces Mrs. Sundby to go to a lower-quality facility. (The Moores website
boasts that it "is one of just 41 National Cancer Institute-designated
Comprehensive Cancer Centers in the United States, and the only one in
the San Diego region.") Mrs. Sundby told this columnist she is uncertain
whether she will be able to return to M.D. Anderson should she need