March 19 2014

Off Limits: Top Cancer Facilities

Patrice J. Lee

ObamaCare’s unintended consequences aren’t just fiscal. New enrollees are learning just how difficult it is to use their new government-sponsored health insurance plans for the life-saving care they need.

The President’s broken promise that if you like your doctor, you can keep your doctor is coming to fruition. To control costs incurred because of new regulations and requirements under ObamaCare, insurers have designed narrow networks of doctors and hospitals. ObamaCare therefore limits access patients have to the care they desire. Patients with cancer or other illnesses that carry high costs are facing this difficult reality firsthand.

According to a new AP survey, some of America's best cancer hospitals are not part of state ObamaCare exchanges.  In fact, only four of 19 nationally recognized comprehensive cancer centers that participated in the survey are a part of the state exchanges. These are institutions that use the latest clinical research and knowledge for patient care, delivering better-than-average survival rates. Cancer patients receive from them hope for survival, healing, and wellness.

While new ObamaCare cancer patients may have access to care through their plans –some potentially for the first time- they will likely not have access to advanced treatment and quality care from the best cancer hospitals. Ill ObamaCare patients are losing choice, a critical tool every patient relies on to seek out the best care and treatment for themselves.

Here’s more on this story:

Some of America's best cancer hospitals are off-limits to many of the people now signing up for coverage under the nation's new healthcare program.

… An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington's insurance exchange. MD Anderson Cancer Center says it's in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more.

Not too long ago insurance companies would have been vying to offer access to renowned cancer centers, said Dan Mendelson, CEO of the market research firm Avalere Health. Now the focus is on costs.


To keep premiums low, insurers have designed narrow networks of hospitals and doctors. The government-subsidized private plans on the exchanges typically offer less choice than Medicare or employer plans.

By not including a top cancer center an insurer can cut costs. It may also shield itself from risk, delivering an implicit message to cancer survivors or people with a strong family history of the disease that they should look elsewhere.


What is a sick person looking to sign up for ObamaCare to do? Well, they should tread quite carefully. As one man from Nevada learned, signing up online and even paying your first month’s premium doesn’t guarantee that your bills will be covered in the event of tragedy.

Sixty-two year-old Larry Basich is on the hook for $407,000 for care he received earlier this year after having a heart attack. He’s caught in a battle between hospitals, insurance brokers, the state exchange and its contractor. In the meantime, hospital bills continue to roll in and the end of the bickering doesn’t appear to be in sight.


Part of the problem for Americans shopping for ObamaCare in the new insurance exchanges is technical. It's not easy for consumers shopping online to tell if top-level institutions are included in a plan. That takes additional digging around by the people applying for coverage. Selecting a plan and hoping for the best becomes a risky proposition when the stakes are your health.

Once again, we have the impact of unintended consequences on full display. Government steps into the private market to fix what it considers broken, but distorts the market and makes a bigger mess.  The un-Affordable Care Act was sold as a necessary reform to the healthcare system that left millions of Americans without healthcare coverage.

Yet, we still don’t know how many uninsured people now have healthcare coverage. The Administration claims they aren’t tracking that metric. And of those who do have new coverage under ObamaCare, they are experiencing limited access to doctors, hospitals, medication, and treatment. We also have new regulations, tax penalties, and greater labor force hardship for American workers.

So, how has ObamaCare has made the lives of Americans better off?

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