Blue Cross Blue Shield (BCBS) of Georgia has told members in its individual markets that they have to start diagnosing themselves before they go to the emergency room. The language isn’t that clear, but that is essentially the bottom line.
Georgia is one of the states that did not expand Medicaid under the Affordable Care Act. The GOP-dominant legislature blocked all the measures to expand because they are heartless imbeciles. What that means in practical terms is that those who cannot pay for their medical coverage are driving up the costs for those who can – namely, the insurance companies. The hospitals can’t get paid because people who should have Medicaid do not. To compensate, they charge insurance companies more. It’s a terrible, vicious cycle. It was an important reason we NEEDED Obamacare.
So, now BCBS has cut emergency coverage of “common ailments”. They will no longer pay for items such as allergies or the common cold. The vast majority of the people in emergency rooms are not medically trained or even knowledgeable. If they feel ill enough to go to the ER, they obviously don’t realize that what they have is classified as a common ailment. What will happen is that these people, who are already paying through the nose for their insurance, will not seek medical care when feeling really ill for the fear of paying out-of-pocket.
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The Medical Association of Georgia’s executive director, Donald Palmisano stated,
What Blue Cross is asking patients do is determine without a clinical background whether their certain situation is truly an emergency, which is a lot to ask of a patient when they’re obviously presenting themselves to the emergency room because they do have concerns. The unnecessary use of emergency departments for ailments that would be better treated at an urgent care center is indeed a real issue, but the solution is better education and preventative and comprehensive care, rather than warning patients their trip to the ER may or may not be covered.
On a different, but relative note, it is important to point out that BCBS is the ONLY insurance provider in 96 of Georgia’s 159 counties. That is a little over 60 percent of the state. By allowing the Medicaid expansion, BCBS’s monopoly would be weakened to allow other Medicaid-approved providers to insure residents. For-profit insurance giants can’t have that, can they?
This just goes to show that the GOP’s primary concern is money – I’m sure there was no incentive in blocking the Medicaid expansion. If you still don’t think that your healthcare is political in every way, you have a lot to learn. Once those babies come out of the womb, all the GOP sees is another dollar sign.