Tuesday, September 11, 2007

What good is health care if no doc will see you?

Yet another problem unfolding in Massachusetts. The state system guarantees "coverage", but of course that's not the same as actual health care.
"What good is health care if no doc will see you?"

Lee Sampson didn't expect to find herself without health insurance. But when her job as a medical transcriptionist got outsourced to India earlier this year, Sampson, 47, had to find a way to get covered.

She found it in Commonwealth Care, a group of subsidized health insurance plans that was created as part of the state's new law requiring people to buy coverage. While the little income Sampson had disqualified her for the state's Medicaid program, the subsidized option was more doable than pricier plans targeting the uninsured from carriers like Harvard Pilgrim and Blue Cross/Blue Shield.

Sampson was enrolled in a plan run by a subsidiary of Boston Medical Center called BMC Health Net. But before her benefits would take effect, she had to find a primary care doctor. That's when her frustration with the new system reached a boiling point.

Sampson started calling primary care doctors within a half-hour drive of her home in Kingston. The response from nearby doctors: "We're not taking (that insurance plan), we're not taking new patients."

Sampson estimated she called about 50 doctors. In some cases, administrators at doctors offices said they didn't know why they were on lists as accepting the insurance when they don’t. In others, they just weren't accepting new patients.

"One woman I talked to said, 'My son is going through the same thing,'" Sampson said. "People are very sympathetic."

Sampson's experience may become more common as residents - many who don't have insurance for financial reasons - scramble to find plans ahead of the Jan. 1 state deadline, after which people lose their state income tax personal exemption of about $219 and face the prospect of stiffer penalties later on.
The government can offer the "stick" of harsh penalties against patients if they don't purchase the state-mandated package. But it can't create actual medical care from thin air. (Via KevinMD.com)