Tags: Barack Obama | Exclusive Interviews | Healthcare Reform | MidPoint | obamacare | insurance | companies

Dr. Elaina George: Obamacare Enriching Insurers

By    |   Wednesday, 18 Feb 2015 06:23 PM

An Atlanta doctor says that sticker shock, delayed care and denials of coverage by insurers are becoming the norm for patients of hers who bought their health plans through the Affordable Care Act (ACA) exchanges.

Elaina George, an otolaryngologist and host of the Internet radio show, "Medicine on Call," offered a bleak assessment of her ACA patients' experiences in an interview with "MidPoint" host Ed Berliner on Newsmax TV Wednesday.

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"As a practicing physician on the front lines, the Obamacare insurance system is not working," said George, meaning for patients that President Barack Obama's prized health-care overhaul was supposed to help.

"People who come to my office who have that [insurance] are just shocked to find out that even though they're paying their deductible, even though they're paying their premium, they can't afford their out-of-pocket costs," she said.

As a result, "people are foregoing treatment," said George. "They're canceling appointments. And I thought the whole point of this was to have people be able to see the doctor, and that's not happening."

Under the ACA, insurance companies save money by limiting policy holders to narrow networks of approved medical providers, an arrangement that discourages patients from going out-of-network for specialized care because it will be partially reimbursed, at best, or not covered at all.

That means decisions about care are increasingly made by the insurers, said George.

"We don't get to choose as physicians what the course of treatment is," she said. "It is now the insurance companies. They're saying what's medically necessary, they're deciding whether something gets covered, and they're denying care left and right.

"I've never seen so many letters of denial come through for everything," said George.

A more consolidated medical industry is another effect of the Affordable Care Act, said George, with physicians and specialists increasingly employed not as independent contractors — George is one — but by large hospital networks with their own mandates to cut costs.

"This is now a centralized medical system where it's done by committee," she said, "and that committee is not based on individualized patient care; it's based on cost."

She said that under the health law's various financial incentives and penalties, doctors are more rewarded for discussing end-of-life care than they are for recommending a CT scan. The new emphasis, she said, is on making very sick people comfortable and preparing them for death, not pulling out all the stops in an attempt to combat and possibly reverse an illness.

"People don't realize that," said George, "but they're not going to be happy when they end up on the other side of that conversation."

Given all that, a Supreme Court ruling against the ACA might not be such a bad thing after the justices hear another challenge to the law in March, she said.

"I personally don't see this as a downfall if they rule against Obamacare," said George.

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An Atlanta doctor says that sticker shock, delayed care and denials of coverage by insurers are becoming the norm for patients of hers who bought their health plans through the Affordable Care Act (ACA) exchanges.
obamacare, insurance, companies, expenses, profits
608
2015-23-18
Wednesday, 18 Feb 2015 06:23 PM
Newsmax Inc.
 

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