The law asks the question whether we want to continue to allow insurance companies to charge more for "out-of-network" care than "in-network" care. I finally found an article that helped me think about it. This article talks about how it is done in New York. In that state, like here, they leave it up to the insurance companies.
Surprisingly, they insurance companies have shown that they prefer closed networks. Why?
The Medical Society’s Mo Auster said that the idea that insurance companies and individual doctors engage in a genuine negotiation — whether concerning fees or medical decisions — is a fiction. Since the insurer’s terms are “pretty much ‘take it or leave it,’” he said, a doctor’s only influence over the process was his or her ability to run a practice without signing up with a network. “The extent to which that ability is minimized,” Auster said, “further enhances the negotiating leverage of the health insurance company to basically take the clinical control away form the doctor.” (Out-of-network coverage in New York? We left it up to the insurers, Remapping The Debate (10/30/2013) (emphasis mine)
This argument is pretty strong:
If you want medical decisions to be just a little more tilted toward insurance company's bottom line instead of the best care for you and your kid, vote no on IM17.
I know there's balance, if the business end of healthcare doesn't work, everyone's care suffers. But I've been reading both sides on this one, and have been a participant in our health-care "system"... and my research and my experience lead me to believe that patients and doctors both are getting the fuzzy end of the lollipop on this one.
And insurers and big hospitals seem to be doing overt well on Main Street and Wall Street.
This isn't as radical an idea as it sounds. If IM17 passes, insurers won't be required to include everyone in their network, the insurers just can't deny providers the opportunity to join the network as long as they agree to meet the insurer's requirements. Today, it's invitation only, like joining a fraternity - I think it make sense to open up the process just a little bit.
I'm voting yes on IM17.