Wednesday, November 13, 2013

What Do You Know? Sarah Palin Was Right

The November 12, 2013 New York Post reports that it isn't just that people are being forced out of health insurance plans that they liked -- the new, far more expensive Unaffordable Care Act-compliant plans actually eliminate coverage for many cancer patients:
To keep costs down, the White House designed ObamaCare plans as cut-rate HMOs. The low profit margins have forced insurers to downsize the number of doctors and hospitals in their networks — and to slash what they cover for out-of-network treatment.
So most ObamaCare plans don’t include the vast majority of the best cancer doctors and cancer centers. That’s a huge problem for these patients. As Dr. Scott Gottlieb, a former Medicare official, writes: “Cancer patients often need the help of specialized doctors and cancer institutions that won’t make it into many of these cheapened networks.”
All across the country, leading cancer centers — including New York’s Memorial Sloan Kettering — are excluded by the largest plans. In Washington state, the largest exchange plans exclude world-class cancer care for kids such as the Seattle Cancer Care Alliance. California’s state-of-the-art Cedars-Sinai cancer center isn’t in any ObamaCare plan. Only a few plans include the Mayo Clinic.
And if you want a doctor outside such networks, you’ll generally have to pay the full cost of care.
This is apparently how Obamacare is going to reduce health care costs -- by making cancer care so expensive that many people won't be able to get it.   Remember how Sarah Palin was an idiot for suggesting that "death panels" were going to determine who would live and who would die?  It appears that Obamacare is going to make the situation very bad indeed for those in the later stages of cancer.

If voters under 35 paid any attention, Obamacare would be the death knell of the Democratic Party.  But I am sure that this will all turn out to be Bush's fault.


  1. This is apparently how Obamacare is going to reduce health care costs -- by making cancer care so expensive that many people won't be able to get it.

    Now, let's be as fair to the other side as we want it to be to us.

    There's a difference between 'cancer care' and 'the best possible cancer care', and we can't pretend there isn't, not if we want our words to have meaning and thus power.

    People do manage to somehow not die of cancer without going to the best possible clinic; we know this because there are cancer treatments done outside of Mayo, CCA, Cedars-Sinai, etc., all the time, quite successfully.

    (Should we complain about excluding those on the basis of cost control, on the Exchange plans?

    Sure; it's absolutely fair to complain about being unable to choose to pay for those things if you want them.

    And it will almost certainly get some people killed because the marginal difference there is a real difference in tricky cases. We can complain about that, with perfect fairness and respect to truth.

    Should we speak as if getting sent to [to use a local example, and one from my family] Kaiser instead of OHSU is the same as not getting cancer treatment?

    No - because it's just not true.)

  2. My liberal friends who are now complaining about Obama, expressing their disappointment, and exhibiting other symptoms of belated buyer's remorse are not amused when I ask them, So, who had the better take on Obama back in 2008: You, or Sarah Palin?

  3. Cancer is not an undifferentiated disease. In fact, it's a large collection of diseases and we keep finding out that what we thought was one cancer has to be subdivided because there are important biological differences that end up being clinically relevant.

    The solution to the differentiation problem is to ask. Here's a good first question. "In what percentages of cancer cases that are diagnosed locally is it clinically beneficial to refer out to a specialized cancer treatment place like Sloan Kettering or Mayo?" Here's a followup that I'm sure that Sloan Kettering has calculated "How do you quantify the number of extra lives that are saved every year by the elevated levels of care that you provide?'

    People don't generally just pop off to Mayo. They get referred by a local doctor who has come to the end of their personal diagnostic skills. Such centers are, in a very real way, guard rails that keep you from going off a health cliff when your local practitioner can't figure out what is wrong.

    Obamacare is taking off the guardrails ad eliminating the safety margin for all patients who can't afford to pay cash for those facilities.

  4. To counter Sigivald's comment somewhat, I would just like to point out that, while you are strictly correct, we /are/ talking about the elimination of plans that cover the costs of these cancer treatment places for /more expensive/ plans that /don't/ cover the costs of these places.

    All because some bureaucrat /thinks/ this will save money, somehow.

    The lesson I really hope we could take from all this is that we shouldn't be giving government the power to tell us what health care insurance we should or shouldn't have. Heck, we shouldn't give that power to our employer, even! That determination /really/ should be in our hands.

    My fear, however, is that just the opposite will happen: that we'll become resigned to government intervention, and the next generation will grow up, thinking this is how things ought to be...