Disappearing patient choice courtesy of private health insurer?

Original Reporting | By Craig Gurian |

We asked Oxford why it counted the way it did, and asked for the actual number of in-network physicians in New York City and in New York State. Gordon-Shydlo said in an email that Oxford’s count was intended to convey the “depth and breadth” of the network — allowing enrollees to see a provider listed as both a primary care doctor and as a specialist — but she did not provide the requested information.

In a follow-up email, we reiterated our request for actual headcount, and asked: “If you wanted to reflect depth and breadth, couldn’t you say, ‘We have X physicians, Y percentage of whom are both primary care physicians and specialists or have two or more specialties’? Wouldn’t that give both pieces of [information]?”

Oxford did not respond.

Additional reporting by Mike Alberti and Althea Webber.

Outspoken in defense of patient choice…but not today

Shortly before publication, Remapping Debate reached out to several members of the House of Representatives who have been outspoken in their opposition to the Affordable Care Act, and who have spoken passionately of the need to preserve a patient’s choice in selecting his or her physician.

We asked each to comment on what appeared to be a private health insurance company’s decision to limit the practical ability of non-wealthy patients to choose an out-of-network doctor.

None responded.

Geoff Davis (R-KY, chair of the Ways and Means Subcommittee on Human Resources). On his website Davis has written: “Unfortunately, many in Congress believe more government control is the answer…American families and small businesses should have the right to chose the health care plan that will fit their needs.  Personal health care decisions must remain between the doctor and the patient…”

Stephen Fincher (R-TN). On his website, Fincher has written: “I will oppose any attempt to increase government intervention in our health care and medical decisions…Patients and doctors should make health care decisions, not government bureaucrats.”

Wally Herger  (R-CA, chairman of Ways and Means Subcommittee on Health). On his website, Herger has written: “I also believe it is important that Republicans present health care reform alternatives that will lower health care costs without growing government. To that end, I have offered legislation that would repeal ObamaCare and replace it with commonsense reforms that keep Washington out of the doctor’s office.”

Randy Neugebauer (R-TX). On his website, Neugebauer has written:  “I will continue to embrace an approach to healthcare that puts patients before profits and politics…making certain that medical decisions are made by patients and their doctors [and letting] Americans who like their health care coverage keep it…”

Devin Nunes (R-CA, member of the Ways and Means Subcommittee on Health). On his website, Nunes has written: “In sharp contrast to the President’s BIG-government plan, my colleagues and I have proposed legislation that centers on choice, affordability and quality.  In our view, the American people deserve a healthcare system that is centered on their individual needs.”

Austin Scott (R-GA). Scott’s website summarizes his position on healthcare as follows: “Austin believes that our healthcare system needs market-based solutions that keep government out of the exam room and maintain the doctor-patient relationship. That’s why he strongly opposes the government takeover of healthcare carried out by Democrats earlier this year.”

Joe Walsh (R-IL, sits on the Small Business Subcommittee on Healthcare and Technology). On his website, Walsh has called the Affordable Care Act “an unconstitutional power grab by the Federal government and an infringement on the freedom of individuals to make their own health care decisions.”

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