[treerex]

Is this really an issue that surprises anyone? If you are paying for a lower tier of insurance then it makes sense to limit the hospital choices available to you. The whole "I'm going to pay less but still want the same level of care as someone paying a premium" attitude needs to go.

[hga]

Wal-Mart doesn't think so. They have a program, can't remember if it's still in the trial stage, where they since employees with particular issues to specialist centers, the theory, which they're collecting data on or have confirmed, is that in the long term this results in better outcomes that are cheaper.

There's very strong reasons to believe this for surgery, since the best determinant of success is how many times a surgeon performed a particular procedure.

[001sky]

The whole "I'm going to pay less ...

That's the fallacy right there. Nobody is paying 'less'. The system is absorbing new risk, so service is being cut. I'm not so sure why that's hard to understand. Read the article, and its quite clear the reportage is about incremental exclusions, required to offset "new costs"...

When the Obama administration was asked whether the new healthcare exchanges were offering adequate network options to new consumers, a spokeswoman for the Department of Health and Human Services (HHS) emphasised that the new exchanges would “vastly increase” the access to medical providers to millions of uninsured Americans.

So, part of the deal is belt-tightening.

[HelloMcFly]

The one area where I wonder about this is Children's hospitals. There's been some stories in Seattle because most of the Washington Health Exchange plans excluded Seattle Children's, which may be a problem for families given that Seattle Children's provides services that other hospitals in the area can't and/or don't.

At least one insurance company in the area has responded by electing to cover unique services provided by Seattle Children's, so that's at least a middle ground.