Tuesday, July 7, 2015

Narrow Networks

I'm subscribing to a paper edition of the Inquirer again. It's kind of like connecting with an old friend (an old friend to whom either time hasn't been kind or who has gone on a diet: it's a noticeably thinner paper now, and I don't know the appropriate metaphor to use). The nice thing about a 20th-century newspaper is that it makes it more likely you read things you might now have done so on your own. A pretty useful article on the Affordable Care Act and "narrow networks" in today's issue is a good example of this.

The article itself is worth a read. The summary could go like this: as a way of cutting costs of coverage, most health plans offered under the ACA put fairly strict limits on which providers one can go to. Typically, one might not be aware of the effect of these limitations until one gets a diagnosis for something severe, such as a cancer, and finds out the specialist one really desires isn't in one's network. The article discussed this tradeoff (more reasonable costs in exchange for more available care) as one which many participants don't know.

Something I find ironic, though, is that this narrow network phenomenon reminds me of what we've been doing in an unrelated field: consumption of media. In the past few years, Americans have been ditching the purchase of CDs and listening to radio in favor of music streaming services. A drawback to consuming music that way is that we tend to narrow our listening choices, and find ourselves less exposed to new music we may like. But we have made this shift to lower the financial cost of consuming music. And so far, it seems most are fine with the tradeoff, too. Cord-cutters like me also have narrowed our field of television that we consume. I found that the plethora of HD channels and DVR box I received from them didn't justify the high cost of my monthly bill to Verizon. Saving about $40 a month, I've narrowed what I can watch and am just fine with the limitations.

There's a chance we're ready to trade-in the bloated expenses of a buffet approach to healthcare in exchange for a lower-priced menu. The limitations on choice and purgatory of referrals doomed HMOs and Hillarycare 20 years ago. Perhaps we've shifted our priorities. Perhaps our eyes aren't bigger than our stomachs anymore.

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