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Obamacare Exchange plans, a ride in the De-Lorean back to the HMO days.


We have driven down this narrow network road before! According to Julie Appleby, Exchange plans are HMOs all over again [emphasis mine]:

It's back to the future for insurers, which plan to sharply limit the choice of doctors and hospitals in some policies marketed to consumers under the health law, starting next fall.
Such plans, similar to the HMOs of old, fell into disfavor with consumers in the 1980s and 1990s, when they rebelled against a lack of choice.

But limited network plans -- which have begun a comeback among employers looking to slow rising premiums -- are expected to play a prominent role in new online markets, called exchanges.

The 90's
Do you remember the good old days of the 90's when the Democrats actually took on, even campaigned on, the injustices created when you limit choices in health plans? Let me refresh your memory.

Minnesota Democrat Mark Dayton is hammering HMOs, and using ridicule as a weapon. One of Dayton's ads declares, "In Minnesota, HMOs have become HNOs. Choose your own doctor. No. Newest medicine? No. Advanced treatment? No."

Find more goodies at the link.

The present
Unfortunately our good Democratic politicians have short memories. According to Media Matters, that liberal bastion and media watchdog:

Narrow Networks Provide Health Care Coverage While Keeping Costs Low


Previous Use Of Narrow Networks Have Been Successful

Well, I guess that depends on your definition of success! If you're worried about corporate profits over anything vaguely resembling care, then yes, narrow networks definitely are a success!

In the (paraphrased) words of James Carville: “If it’s so great, run on dat!”
Using Washington state as an example again (my apologies)...Children’s Hospital and Seattle Cancer Care Alliance are two last resort hospitals that people travel from other states to literally receive life-saving treatments. Is eliminating them from our Exchange networks a good way to ensure that consumers get "meaningful coverage [which] will give people peace of mind and financial security?" If so, then why isn’t our Governor Jay Inslee and Insurance Commissioner Mike Kreidler mentioning them when they talk about how the rates are "lower than expected". Why aren't they shouting this to the rooftops? Why aren't they running on the virtues of limiting consumer choices to "save money"? Why aren't they "running on dat?"

My presumption of the future
We rejected narrow networks in the 90’s and I believe we will reject them again -- but not before people endure severe costs just as they did in the 80's and 90's.

Obamacare was supposedly about choices.

No votes yet


Submitted by lambert on

I think they are the doctor's office aspect of HMOs (as narrow networks are the business model aspect). I believe that ObamaCare pushes them, too, but they are HMO wine in new bottles, and they can't be shown to work which hasn't stopped "consultants" and experts from pushing them.

Insanity is doing the same thing and expecting a different result....

NOTE Accountable Care Organizations.

Richard Lyon's picture
Submitted by Richard Lyon on

Everything I have read about people reacting to the limitations that the exchange plans impose on their health care choices sound exactly like HMOs to me. I wasn't aware that HMOs had gone away. I got bounced around from one community based HMO to another in San Francisco in the 90s. I finally wound up with Kaiser and I like it much better. I find it an efficient way to provide mass health care.

It seems to me that if you choose to leave the private insurance industry in control of the game this is about what you can expect to wind up with for a plan that has a somewhat lower cost.

Alexa's picture
Submitted by Alexa on

it seems that the masses today are somewhere between "being much more apathetic, and being much more guillible and/or malleable." [Can't figure out which!]

Considering the fact that many liberal news and opinion organizations "spin" corporate memes so effectively, I guess it shouldn't come as a surprise.