I’ve been in the health insurance business for 30 years. Like just about everything in life this business is cyclical. There was a time in the health insurance business when HMO’s were the least expensive option for individuals and employers. Receive your medical care from a limited list of physicians and hospitals and your health insurance premiums drop. Today if you were to buy an HMO plan you would be paying the highest premiums in the country. This is because HMO’s generally offer first-dollar coverage. Very low deductibles and very low out of pocket expenses means very high premiums.
Well here we go again. New health plans being offered have about half the number of doctors and hospitals to choose from. Insurers can control costs by contracting with a limited number of hospitals and doctors, guaranteeing these entities plenty of customers and making up for the lower reimbursement rates through volume of patients. There is already a doctor shortage. Add limited lists of doctors one is able to see and it becomes obvious where this is heading, long waits.
Michael Higgins
602.405.8769