Seattle Children’s Hospital Suing Obamacare after Denying Coverage to Kids


#1

Some perspective here. Seattle Children’s is THE regional children’s hospital. I am a nurse in another part of the State of Washington. Children’s is where all our complex cases are referred. ANY child in our ER with a complex medical problem gets referred to Children’s.

Another perspective— Western Washington is firmly a Democratic, Obama loving stronghold.

Seattle Children’s Hospital is taking legal action to correct a “false promise” of Obamacare. With only two out of the seven plans offered under Washington State’s health-care exchange covering treatment at the hospital, one of the state’s key providers of specialized pediatric care, it will sue the state’s insurance commissioner for “failure to ensure adequate network coverage.”

“The exclusion of a major provider like Seattle Children’s for a major insurance network in this market is unprecedented,” said Dr. Sandy Melzer.

nationalreview.com/corner/370734/seattle-childrens-hospital-suing-obamacare-after-denying-coverage-kids-andrew-johnson


#2

Very interesting to see this happening in the state of Washington - where people seem to worship Obama. Yet, we are seeing the ill effects of Obamacare and even liberals seem to be having second thoughts. This gives me hope.

Ishii


#3

Where are the parents in all of this? How could they not have known Seattle Children’s was not in network? Every insurance site I have visited recently, and healthcare.gov as well, advises on how to choose a plan and part of that advice is to check which providers are in network.

If the children were not able to get care period, I could see a problem, but if the parent had a chance to choose a plan with Seattle Children’s on it and they chose not to (or could not afford the plans that include it), then of course they have to take their kids elsewhere.

Insurance companies drop hospitals and practices all the time, but specialty hospitals are probably less used to that experience hence the shock reaction. Insurance companies seem to be dropping them because of costs…but wait, isn’t that how the market is supposed to work: stuff too expensive at one provider, go next door?


#4

Sounds as if the parent’s (distraught!) are not allowed to have a say with all knowledge, if all children’s complex medical problems are referred there. Due to the referral they would just think care was automatically covered. A little part of me thinks so even tho’ I know better and have more knowledge about medical insurance than many. They wouldn’t have payed any attention to Seattle Children’s when they picked out the plan.


#5

Parents have a say - they just don’t know it. The whole referral system is another part of why costs are so high. What is really the difference between an MRI done at the university center versus the one done at the stand-alone facility down the street for $500 less, particularly if the same doctor is interpreting both? Is there a difference in quality? Maybe yes, maybe no. But if the one making the referral is not comparing both quality AND cost, then we have a problem of referral decisions being unhinged from cost considerations.


#6

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