Tom Coburn: My new ObamaCare coverage won’t cover treatment from my cancer specialist

posted at 2:41 pm on January 28, 2014 by Allahpundit

Via the Free Beacon, a vivid illustration of how the Affordable Care Act keeps coverage “affordable.” All you need to do is exclude the pricier doctors and hospitals, like Cedars-Sinai in L.A. and Sloan Kettering in New York, from a plan’s provider network, and voila — savings.

Savings?

The top lobby group for US health insurance plans, America’s Health Insurance Plans, said the new healthcare law brought “new costs” to the industry and that selecting hospitals and physicians that meet “quality standards” was one way of making health plans more affordable for consumers.

But Mr Priselac at Cedars-Sinai in Los Angeles says the creation of ever more narrow provider networks by insurers is being driven by price alone, and not by quality. He says the hospitals that are being excluded are leaders in innovation, which saves billions of dollars for the healthcare system in the long run.

Coburn didn’t reveal who his doctor is, but needless to say, losing your doctor is not an uncommon experience in the new golden age of “universal” health care, even for cancer patients.

The Oklahoma Republican’s spokesman confirmed to POLITICO that since the senator enrolled in his health insurance plan under Obamacare, his coverage has been reduced and he lost coverage for his cancer specialist. Coburn will continue to pay out of his own pocket and see the oncologist, his office said…

“We hope the White House will work with us to make sure Americans who can’t afford to pay out of pocket don’t lose access to life-saving care,” spokesman John Hart said. “As Dr. Coburn’s experience shows, the American people are about to learn they’re going to lose access to not only their doctors and plans, but their specialists and treatments.”

Have provider networks shrunk that much even among “gold” and “platinum” plans on the exchanges? That’s what Coburn, who’s already survived previous bouts with cancer, would have purchased, I assume. It’s no secret that “bronze” and “silver” plans help pay for their lower premiums by keeping provider networks comparatively small; I assumed one of the benefits for shelling out for a cadillac plan would be a robust network. Not robust enough, apparently.

If you missed it in Headlines yesterday, read Philip Klein’s critique of Coburn’s proposed alternative to ObamaCare. It’s not a wholly new paradigm so much as an overhaul of O-Care itself — higher premiums for the old to provide relief to the young, coverage for preexisting conditions only if the insured has maintained continuous coverage, retaining the employer health insurance tax exclusion (albeit with a cap), and so forth. My sense of it is that it’s not meant as a permanent Republican replacement for O-Care but rather as a proposal that might attract centrist Democrats in the short-term. Get Democrats to accept a more liberalized version of ObamaCare now and then try to build on that to open them up to more ambitious reforms later.


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Don’t worry, the economy will save the Dems.

NotCoach on January 28, 2014 at 2:44 PM

My sense of it is that it’s not meant as a permanent Republican replacement for O-Care but rather as a proposal that might attract centrist Democrats in the short-term. Get Democrats to accept a more liberalized version of ObamaCare now and then try to build on that to open them up to more ambitious reforms later.

Seems like a good idea to me.

ojfltx on January 28, 2014 at 2:45 PM

Yeah, I saw this at Drudge earlier…

OmahaConservative on January 28, 2014 at 2:45 PM

Deliver Us from the Evil of ObamaCare.

viking01 on January 28, 2014 at 2:46 PM

While getting completely rid of Ocare is the ultimate goal, waiting 3 years and hoping we gain both houses of Congress and presidency isn’t an option either. Do what we can to help, proving free market solutions would work.

Tater Salad on January 28, 2014 at 2:48 PM

Time to start cooking meth in the RV.

Mark1971 on January 28, 2014 at 2:48 PM

Same thing happened to one of my aunts, who has ovarian cancer.

Thank You, President O’bama.

Del Dolemonte on January 28, 2014 at 2:48 PM

How will the Dems feel when we start having “body counts” on the effects of Ocare.

Tater Salad on January 28, 2014 at 2:49 PM

Well Tom, I just don’t know what to say to you.

Get lost, sore loser, stock up on aspirin, etc. These come to mind.

You know why I feel that way, Tom? Because the story says you’ll just pay for it out of your own pocket. Thats great.

So now tell us

1) why we should give a damn that you lost your coverage (not really, you just have pay for it yourself)

2) what would you say to someone in your position who didn’t spend a considerable amount of time in Congress and managed to enrich himself while he was there, and will now most likely die of cancer that was otherwise treatable…. at least until there was a universal healthcare initiative?

BobMbx on January 28, 2014 at 2:49 PM

Have provider networks shrunk that much even among “gold” and “platinum” plans on the exchanges?

When I was examining the networks for Blue Shield of California’s Obamacare plans I saw no difference between the platinum and bronze plans. Same networks.

Mark1971 on January 28, 2014 at 2:50 PM

Meh, Dog Eater has a pen and with a simple signature he can make anything work; dictators are good in that way.

Bishop on January 28, 2014 at 2:50 PM

Obama was such a good friend, huh, Senator Coburn?

22044 on January 28, 2014 at 2:51 PM

Tom Coburn: My new ObamaCare coverage won’t cover treatment from my cancer specialist

.
So … you’re a Republican !

What did you expect, an ‘exemption’ ?

listens2glenn on January 28, 2014 at 2:53 PM

Del Dolemonte on January 28, 2014 at 2:48 PM

Sorry about your aunt, Del. That’s awful.

Christien on January 28, 2014 at 2:54 PM

BobMbx on January 28, 2014 at 2:49 PM

Not sure I understand your complaint here – single payer will have zero access to any of the hospitals or docs you would want to see. So the same problem will remain. Under the old system, many people could see these facilities. Right now these facilities are busy laying off support staff and lower level provider personnel in order to deal with their own cash flow issues they are experiencing with the advent of OCare.

Zomcon JEM on January 28, 2014 at 2:57 PM

When I was examining the networks for Blue Shield of California’s Obamacare plans I saw no difference between the platinum and bronze plans. Same networks.

Mark1971 on January 28, 2014 at 2:50 PM

The only difference between the various plans offered by a single insurer in ObamaCare are increased premiums vs. reduced deductibles and co-pays. The only choice in this crap sandwich is to pay at the front end, or to pay at the back end.

NotCoach on January 28, 2014 at 2:57 PM

Same thing happened to one of my aunts, who has ovarian cancer.

Thank You, President O’bama.

Del Dolemonte on January 28, 2014 at 2:48 PM

People should keep seeing their old doctors then send the bill to the WH since Obama promised we could keep our doctor.

NotCoach on January 28, 2014 at 2:58 PM

Meh, Dog Eater has a pen and with a simple signature he can make anything work; dictators are good in that way.

Bishop on January 28, 2014 at 2:50 PM

.
What Bishop really meant is benevolent dictators are good in that way.
Because they really want the best for their subjects people.
.
.
( dang Bishop … what are tryin’ to do … get us all shot ? )

listens2glenn on January 28, 2014 at 2:59 PM

Get lost, sore loser, stock up on aspirin, etc.

BobMbx, you can shine your shoes and wear a suit. You can comb your hair and look quite cute.

cbenoistd on January 28, 2014 at 3:00 PM

Tom Coburn: My new ObamaCare coverage won’t cover treatment from my cancer specialist

Tom, We’ve known this for years, why are you telling us?

You should be writing a note to your best friends, Barack Obama, Harry Reid and the “nice lady” Nancy Pelosi.

RJL on January 28, 2014 at 3:02 PM

listens2glenn on January 28, 2014 at 2:59 PM

Right. The feds are going to bust down my door and make me disap

Bishop on January 28, 2014 at 3:05 PM

Yeah, but it’s not like a death panel or anything.

John the Libertarian on January 28, 2014 at 3:05 PM

Say Hello to your suite mate

http://cdn.frontpagemag.com/wp-content/uploads/2010/03/cuba-hospital.jpg

roflmmfao

donabernathy on January 28, 2014 at 3:05 PM

Same thing happened to one of my aunts, who has ovarian cancer.

Thank You, President O’bama.

Del Dolemonte on January 28, 2014 at 2:48 PM

Remember when the left said that the Republican health care plan was ‘die sooner?’

Yeah. Funny, that.

tdpwells on January 28, 2014 at 3:07 PM

This is really going to create a two-tied healthcare system where the rich people and the government officials get the best doctors at the best hospitals, and the rest of us get marginal doctors at the lesser tier hospitals. FAIRNESS!

LilyBart on January 28, 2014 at 3:09 PM

How will the Dems feel when we start having “body counts” on the effects of Ocare.

Tater Salad on January 28, 2014 at 2:49 PM

Successful?

Dr. ZhivBlago on January 28, 2014 at 3:16 PM

Well Tom, I just don’t know what to say to you.

Get lost, sore loser, stock up on aspirin, etc. These come to mind.

You know why I feel that way, Tom? Because the story says you’ll just pay for it out of your own pocket. Thats great.

So now tell us

1) why we should give a damn that you lost your coverage (not really, you just have pay for it yourself)

2) what would you say to someone in your position who didn’t spend a considerable amount of time in Congress and managed to enrich himself while he was there, and will now most likely die of cancer that was otherwise treatable…. at least until there was a universal healthcare initiative?

BobMbx on January 28, 2014 at 2:49 PM

And this, my friends, is what is wrong with liberals, example #121234254353469654878.

Senator Coburn doesn’t want sympathy. Senator Coburn is highlighting his personal example becase he’s concerned about “someone in (his) position who didn’t spend a considerable amount of time in Congress and managed to enrich himself while before he was there, and will now most likely die of cancer that was otherwise treatable”.

Your hero just sentenced that person to death. And all you can bleat is “but, but, but, UNIVERSAL HEALTHCARE will solve it!”

makattak on January 28, 2014 at 3:17 PM

Tom Coburn: My new ObamaCare coverage won’t cover treatment from my cancer specialist

The best thing the republicans ever did was stick an amendment to force the congress critters to join OboobieCare. Embrace the suck on one hand and on the other, may more of them be blessed with interesting OboobieCare coverage over the next few months.

AH_C on January 28, 2014 at 3:20 PM

This is no surprise to many of us with a chronic disease. My neurologist, who has been treating my multiple sclerosis for years decided he can’t maintain a practice with all the new rules, regulations and fees under ObamaCare and quit his practice. He and his family moved back to Hydrabad where he can run his practice the way he wants and the way it’ll benefit his patients without a lot of federal government interface.

simkeith on January 28, 2014 at 3:22 PM

A lot of Californians are about to find out that they have also lost their Doctors.

Covered California clients have trouble finding doctors
Victoria Colliver
Updated 8:57 pm, Thursday, January 23, 2014

Think signing up for health insurance through Covered California is hard? Some consumers say the real battle starts when it comes to finding a doctor or hospital that will take a plan purchased through the state-run health exchange.

But now that coverage has started, some people are finding it tough to determine whether their doctor or hospital will accept their coverage. Consumers say the insurer’s directory of doctors and hospitals is inaccurate or out of date. In some cases, the doctors don’t even know what to tell their patients. “There’s a lot of confusion. The physicians don’t know if they’re actually participating” in the exchange’s networks, said Donald Waters, executive director of the Alameda-Contra Costa Medical Association, which represents 3,100 doctors in the East Bay.

The problem is not limited to California. A study released last month by the consulting group McKinsey found that many plans sold through the federal health law are using “narrow” or “ultra narrow” networks – physician and hospital lists that are limited to lower costs.

In more than two-thirds of all exchange networks analyzed by McKinsey, at least 30 percent of the largest 20 local hospitals were excluded. Insurers say the move to limit the number of doctors and hospitals on a network was necessary to keep the costs of premiums low.

In California, plans offered by Blue Shield through Covered California included just 60 percent of the doctors that participate in the insurer’s group plans and just 75 percent of the hospitals. On top of that, Blue Shield is reimbursing doctors and hospitals in Covered California policies up to 30 percent less than those not in the exchange, spokesman Stephen Shivinsky said.

Kearney had even opted for more comprehensive coverage including a PPO, or preferred provider organization plan. “I chose a PPO so I could have had choice,” she said. “The thing is, now I have nothing to choose from.”

http://www.sfgate.com/health/article/Covered-California-clients-have-trouble-finding-5169944.php

Sometimes it is really hard to resist the urge to say “We told you so!”

wren on January 28, 2014 at 3:23 PM

“We hope the White House will work with us to make sure Americans who can’t afford to pay out of pocket don’t lose access to life-saving care,” spokesman John Hart said

He said that with a straight face?
That’s exactly what Obamacare has accomplished and made sure of..
Prior, those who could not afford to pay out of pocket did not have access to life-saving care.

verbaluce on January 28, 2014 at 3:39 PM

Alright, who let verby out?!

22044 on January 28, 2014 at 3:47 PM

If you like your pre-existing conditions, you can keep your pre-existing conditions.

Sgt Steve on January 28, 2014 at 3:49 PM

Prior, those who could not afford to pay out of pocket did not have access to life-saving care.

verbaluce on January 28, 2014 at 3:39 PM

How can a person be so Fluking ignorant? Nobody was denied life saving care before ObamaCare. Health insurance does not equal healthcare, and there were state and federal laws prior to ObamaCare that dictated persons could not be denied care.

Now, how do you jibe this colossal bit of ignorance on your part with the notion that our healthcare system was bankrupting everyone? How is it possible to bankrupt anyone if they’re being denied care because they aren’t likely to pay for it?

Logic doesn’t matter? Just throw everything at the wall in your ignorant quest to wreck everything?

NotCoach on January 28, 2014 at 3:50 PM

Obamacare is just going to insure that many more people are going to go bankrupt using the health care system.

Winner for the anti-human left.

Murphy9 on January 28, 2014 at 3:51 PM

Obamacare is just going to insure that many more people are going to go bankrupt using the health care system.

Winner for the anti-human left.

Murphy9 on January 28, 2014 at 3:51 PM

Verbalidiocy begs to disagree. Apparently before more people became uninsured after ObamaCare, and prices were lower before ObamaCare, no one ever went bankrupt because everyone was denied care.

NotCoach on January 28, 2014 at 3:53 PM

This is going to happen to me when the employer mandate kicks in.

I figure the president wants me dead. The feeling is mutual.

juliesa on January 28, 2014 at 3:54 PM

verbaluce on January 28, 2014 at 3:39 PM

Incorrect, Troll.

Previously, those who could not afford to pay out of pocket (Most people) had private or employer-provided health insurance. (total uninsured adults was around 7% of the populace, most of them by choice.) Now the private market is DEAD, killed by Obamacare.

However, that was just the small potatoes. Wait until Obamacare kills the employer provided market! We will literally have a rolling body count as the number of people dying from otherwise treatable diseases starts racking up.

And it will be your fault and the fault of all who voted this moron into office. I wouldn’t want your karma. I suspect your next several lifetimes will be spent as fecal coli-form bacteria.

Hmm. Then again, it won’t be much of a change from your current state. Maybe you won’t notice.

wearyman on January 28, 2014 at 3:56 PM

verbaluce on January 28, 2014 at 3:39 PM

You’re an effing moron. The only plan I can afford is bronze and with a a family deductilbe of 12k I STILL HAVE TO PAY OUT OF POCKET YOU FVCKING IDIOT.

BeachBum on January 28, 2014 at 3:58 PM

He said that with a straight face?
That’s exactly what Obamacare has accomplished and made sure of..
Prior, those who could not afford to pay out of pocket did not have access to life-saving care.

verbaluce on January 28, 2014 at 3:39 PM

Have you not been keeping up with ObamaCare or are you just drunk?

Chuck Schick on January 28, 2014 at 4:01 PM

juliesa on January 28, 2014 at 3:54 PM

I’m worried about my kids. I have 2 kids with medical needs. My eldest takes several medications to help modify her more extreme behavior problems stemming from her ASD. (She is a mostly non-verbal Autistic child with self-destructive and aggressive tendencies since birth. Her meds keep her stable and able to function as much as she can.)

My youngest has Spina Bifida. She takes a regular regimen of antibiotics to ward off infections from being catheterized multiple times per day (so she can pee). That’s over and above the medications she takes to keep her bladder muscles relaxed so her urine doesn’t back up into her kidneys and kill her. Oh, and there is the cost of her physical therapist and the braces for her ankles so she can walk AT ALL.

So we are pretty dependent on our employer provided insurance to cover all of these costs as we could never afford them out of pocket. Our daughter’s Neurologist, orthopedic surgeon and several other doctors and specialists are NOT in the network of any Obamacare compliant private plan. I don’t expect the Obamacare compliant employer provided plans to be any better. Which means if Obamacare isn’t gotten rid of and SOON, my daughter’s LIFE is at stake.

I cannot describe what the soul-crushing fear of having the government essentially come in and threaten the life of your child is like. We MUST get rid of Obamacare, and FAST!

wearyman on January 28, 2014 at 4:09 PM

Nothing a few website fixes wouldn’t clear right up!

Ed –
You mean the websites aren’t working perfectly on day one two three four five six seven eight nine ten eleven twelve thirteen fourteen fifteen sixteen seventeen eighteen nineteen twenty twenty-one twenty-two twenty-three twenty-four twenty-five twenty-six twenty-seven twenty-eight twenty-nine thirty thirty-one thirty-two thirty-three thirty-four thirty-five thirty-six thirty-seven thirty-eight thirty-nine forty forty-one forty-two forty-three forty-four forty-five forty-six forty-seven forty-eight forty-nine fifty fifty-one fifty-two fifty-three fifty-four fifty-five fifty-six fifty-seven fifty-eight fifty-nine sixty sixty-one sixty-two sixty-three sixty-four sixty-five sixty-six sixty-seven sixty-eight sixty-nine seventy seventy-one seventy-two seventy-three seventy-four seventy-five seventy-six seventy-seven seventy-eight seventy-nine eighty eighty-one eighty-two eighty-three eighty-four eighty-five eighty-six eighty-seven eighty-eight eighty-nine ninety ninety-one ninety-two ninety-three ninety-four ninety-five ninety-six ninety-seven ninety-eight ninety-nine one hundred one hundred one one hundred two one hundred three one hundred four one hundred five one hundred six one hundred seven one hundred eight one hundred nine one hundred ten one hundred eleven one hundred twelve one hundred thirteen one hundred fourteen one hundred fifteen one hundred sixteen one hundred seventeen one hundred eighteen one hundred nineteen one hundred twenty
verbaluce on October 1, 2013 at 10:18 AM

(H/T NotCoach)

There Goes the Neighborhood on January 28, 2014 at 4:33 PM

My new ObamaCare coverage won’t cover treatment from my cancer specialist

Ah, so this is how the Dems expect to escape the wrath of voters… just kill off all their competition with exemptions placed on key groups such as Unions which normally vote Dem. You keep their congressmen and voters alive you eventually gain a majority.

Ukiah on January 28, 2014 at 4:39 PM

“We hope the White House will work with us to make sure Americans who can’t afford to pay out of pocket don’t lose access to life-saving care,” spokesman John Hart said

He said that with a straight face?
That’s exactly what Obamacare has accomplished and made sure of..
Prior, those who could not afford to pay out of pocket did not have access to life-saving care.

verbaluce on January 28, 2014 at 3:39 PM

Something tells me verbie never heard of EMTALA.

Compare the situation before Obamacare, and the situation after. After Obamacare, premiums are higher, deductibles are higher, clinic and doctor networks are smaller, and more people are uninsured.

But hey, they oughtta get those websites fixed any day now, right? Right?

There Goes the Neighborhood on January 28, 2014 at 4:47 PM

But Mr Priselac at Cedars-Sinai in Los Angeles says the creation of ever more narrow provider networks by insurers is being driven by price alone, and not by quality. He says the hospitals that are being excluded are leaders in innovation, which saves billions of dollars for the healthcare system in the long run.

Seriously, what did you expect them to be driven by? Health insurance companies have far higher expenses, and they’ve already had to jack up the premiums and the deductibles in order to make ends meet. Reducing quality is about the only thing they have left to keep from going broke.

The irony, of course, is that some of them saw the promise of a mandate and thought this would be a good thing for their business.

There Goes the Neighborhood on January 28, 2014 at 4:52 PM

Hey, look on the bright side. OCare is providing a lot of stimulus to a few blue states. That’s gotta be good, right?

ObamaCare Dumped $1.2 Bil Into Failing State Exchanges

climbnjump on January 28, 2014 at 5:01 PM

No plan, no doctor, no hospital.

“You lie”…the truest thing ever said about obama.

Schadenfreude on January 28, 2014 at 5:13 PM

Just for ha ha’s i looked up tom coburn-he turned 65 march 2013.

he will be on medicare anyway.

gerrym51 on January 28, 2014 at 5:27 PM

“….centrist Democrats….”

Puh-leeze! One is more likely to find a herd of unicorns than a centrist democrat.

olesparkie on January 28, 2014 at 6:30 PM

“Die quickly” is a cost-saving plan.

vityas on January 28, 2014 at 7:00 PM

Prior, those who could not afford to pay out of pocket did not have access to life-saving care.
 
verbaluce on January 28, 2014 at 3:39 PM

 
How can a person be so Fluking ignorant? Nobody was denied life saving care before ObamaCare. Health insurance does not equal healthcare, and there were state and federal laws prior to ObamaCare that dictated persons could not be denied care…
 
NotCoach on January 28, 2014 at 3:50 PM

 
From almost exactly one year ago:
 

That’s cute that you think a surgical office capable of repairing a complicated fracture is too inept to set up a 48 month payment plan.
 
Your cited $33,565 is almost exactly the cost of a new Chevy Impala, and people buy those every day:
 
rogerb on February 2, 2013 at 4:48 PM

rogerb on January 28, 2014 at 7:03 PM

Your hero just sentenced that person to death. And all you can bleat is “but, but, but, UNIVERSAL HEALTHCARE will solve it!”

makattak on January 28, 2014 at 3:17 PM

Oh my.

I’m no liberal. At all. My complaint about Tom is that he was a member of Congress when this legislative abortion was passed. He didn’t vote for it. He didn’t stop it, either. His side lost. That makes him a loser. He was sent to Congress to represent conservative values and failed. This assessment applies to each and every “conservative” in Congress the day the vote was held.

Tom failed me. I couldn’t care less about his troubles. I’ve got my own to deal with.

BobMbx on January 28, 2014 at 9:21 PM

The Obamacare Plan: make it as unaffordable as possible, take away all the good hospitals, make the pool of Drs and hospitals real small, and let those with pre-existing conditions, flail about needing a Dr, cuz they can’t keep the ones they have and hopefully they will die off waiting to get Health Care…wash rinse and repeat ad infinitum…

Scrumpy on January 29, 2014 at 1:34 AM