Obamacare: You also can't keep your doctor

I had great cancer doctors and health insurance. My plan was cancelled. Now I worry how long I'll live.

By Money Staff Nov 4, 2013 5:00PM

This post, by Edie Littlefield Sundby, appeared in the Opinion section of partner site The Wall Street Journal.

 

The Wall Street Journal on MSN MoneyEveryone now is clamoring about Affordable Care Act winners and losers. I am one of the losers.

 

My grievance is not political; all my energies are directed to enjoying life and staying alive, and I have no time for politics. For almost seven years I have fought and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2 percent after diagnosis. I am a determined fighter and extremely lucky. But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31.

My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40 percent to 50 percent more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.

 

Countless hours searching for non-exchange plans have uncovered nothing that compares well with my existing coverage. But the greatest source of frustration is Covered California, the state's Affordable Care Act health-insurance exchange and, by some reports, one of the best such exchanges in the country. After four weeks of researching plans on the website, talking directly to government exchange counselors, insurance companies and medical providers, my insurance broker and I are as confused as ever. Time is running out and we still don't have a clue how to best proceed.

 

Two things have been essential in my fight to survive stage-4 cancer. The first are doctors and health teams in California and Texas: at the medical center of the University of California, San Diego, and its Moores Cancer Center; Stanford University's Cancer Institute; and the M.D. Anderson Cancer Center in Houston.

 

The second element essential to my fight is a United Healthcare PPO (preferred provider organization) health-insurance policy.

 

Surgeons operating on patient © Pete Saloutos, UpperCut Images, Getty Images

Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team. The company pays a fair price to the doctors and hospitals, on time, and is responsive to the emergency treatment requirements of late-stage cancer. Its caring people in the claims office have been readily available to talk to me and my providers.

 

But in January, United Healthcare sent me a letter announcing that they were pulling out of the individual California market. The company suggested I look to Covered California starting in October.

 

You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so. UCSD has agreed to accept only one Covered California plan -- a very restrictive Anthem EPO Plan. EPO stands for exclusive provider organization, which means the plan has a small network of doctors and facilities and no out-of-network coverage (as in a preferred-provider organization plan) except for emergencies. Stanford accepts an Anthem PPO plan but it is not available for purchase in San Diego (only Anthem HMO and EPO plans are available in San Diego).

 

So if I go with a health-exchange plan, I must choose between Stanford and UCSD. Stanford has kept me alive -- but UCSD has provided emergency and local treatment support during wretched periods of this disease, and it is where my primary-care doctors are.

 

Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines.

What happened to the president's promise, "You can keep your health plan"? Or to the promise that "You can keep your doctor"? Thanks to the law, I have been forced to give up a world-class health plan. The exchange would force me to give up a world-class physician.

 

For a cancer patient, medical coverage is a matter of life and death. Take away people's ability to control their medical-coverage choices and they may die. I guess that's a highly effective way to control medical costs. Perhaps that's the point.

 

Ms. Sundby lives in California.

 

More from The Wall Street Journal:

 

 

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2030Comments
Nov 4, 2013 5:31PM
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I am so sorry :-(  This is what we have been trying to warn EVERYONE about. But no one would listen to us. This administration is a farce, one big lie after lie. I hope you find what you need, but I am doubtful.
Nov 4, 2013 6:16PM
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a lot of you are missing the point... The President is TAKING AWAY the right for an AMERICAN to decide their own  LIFE, LIBERTY or PURSUIT of HAPPINESS. This law is taking over our choices without our permission. We used to have control of our own destiny but this another step to socialism because people are not willing to stand up & FIGHT for their freedom to choose. Remember the American revolution. This is a clear case of taxation without any benefit to the PEOPLE who are taxed. The socialistic government will benefit w/our money to pay for more & more socialistic programs and we will continue to be a country of  complacent, do nothing  "puppets" .    
Nov 4, 2013 5:31PM
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Start impeachment process, NOW!!!  Get this lying clown and his minions out of office, NOW!!!
Nov 4, 2013 5:57PM
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Republicans and honest media have been explaining the problems with Obama care for years.  Obama had to know or he is the most stupid incompetent president in history.  Since he knew he is a liar that means he deliberately looked into the camera and lies just to deceive for his political purposes.  All the Democrat leaders have done the same thing.  If you give this deception a pass because you support Obama you are lacking in morals, ethics, and character just like Obama and the Democrat leaders.

Obama was given an out when the Republicans offered to delay Obama care for a year.  Many of the problems could have been changed.  Obama refused, the Democrats in congress refused.  Now don't delay any part.  Congress should force the Business Mandate to start on time and it was illegal for Obama to give the delay.  Throw the mess out to the public can just see what was passed by secret meetings, bribes, coercion. using a devious procedure called deeming to avoid getting 60 votes, and not even giving a few days for the members to even read the bill.  Bet most still have not read it all even "you have to pass it to find out what's in it" Pelosi.

Nov 4, 2013 6:07PM
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I know someone facing a similar situation.  He has been a quadriplegic for more than 20 years and is dependent on MediCal and SSI income.  Recently his caregiver sent off his monthly order for medical supplies, only to be told that MediCal had flagged his file that no more supplies were to be provided to him.  Likewise, his pharmacist was told to stop dispensing the intravenous antibiotics that help him keep certain infections at bay.

 

My friend feels as if he has been bumped to the head of the "marked for death" line.  This is what you get with rationed care; some people are deemed by the powers that be to be less worthy of receiving the care that they need to stay alive.

 

Luckily for my friend, both the medical supply house and his pharmacist have elected to ignore the state's dictates for now.  They may end up paying a financial price, but both feel the moral price they would pay would be far greater.

 

Welcome to the wonderful world of Obamacare.

Nov 4, 2013 6:07PM
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I'm sure we are going to find out more as we keep peeling back the layers on this "onion" called Obamacare.  And it won't be for the better.  It looks like all this expense is being placed on the backs of the middle class so that others can have more affordable insurance.  It's going to get to the point that the millions who've had their policies cancelled will just pay the penalty, as it will be cheaper than the insurance they now can't afford.  What was supposed to put millions on the insurance rolls will now create even more UNINSURED, especially the middle class!
Nov 4, 2013 5:52PM
Nov 4, 2013 5:19PM
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Who have you voted for during the last 10 years? If you voted these clowns in, I have no sympathy for you.
Nov 4, 2013 6:46PM
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This is truly heartbreaking and I am sure this poor lady is not alone. How many more millions will lose their plans and doctors because of this lying imbecile. This feckless fool's administration has been a bad joke from day one. Its amazing that anyone still supports this train wreck.

Nov 4, 2013 5:55PM
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Well  some people wanted change , this is change  alright . Change for the worse!!! See? Your redonkulous slogans don't solve everything clownbama .

Nov 4, 2013 8:17PM
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Wow, does my heart ever go out to this family.  My disgust for our president has no limits. He lied to the American people about health care to push his socialist, "rely on government"  agenda.  It is time to impeach him.  What bigger crime or misdemeanor against us under the Constitution can you name than  lying to the American people about things may well cost them their lives?  
Nov 4, 2013 7:03PM
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democrat = the lyin sack of 5hit party .
Nov 4, 2013 7:56PM
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Well, I think I have the "poor me" out of my system for a while.  Now I can get down to business and look at the larger, bigger issue here.  I am old enough to have grandchildren who are young adults, or soon will be.  What about them?  Obama's apparent plan is to have the young people pay for us older people's health care.  One glaring problem -- we have a large segment of our young adults who cannot even find work, let alone afford to pay large health care insurance premiums.  They have a difficult enough time to put a roof over their heads, afford 3 squares-a-day, and pay for all the other government imposed penalties for being young Americans.  We are going to have generations of hopeless, unenthusiastic, depressed, people who will have just given up on the "American dream".  There is an immediacy about this current healthcare issue, but this is just a symptom of a much larger issue -- a government who has lost its way in the political wranglings over trivial issues, while losing sight of what is really important -- preserving this great nation for the generations to come.
Nov 4, 2013 5:34PM
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Obama don't care.  What a idiot.  What part of no does he not understand.  If people want to sign up for his crap let them.  Everyone should be able to go with what work's for them.  Believe in you and you'r  lying mouth forget it.
Nov 4, 2013 5:20PM
Nov 4, 2013 8:11PM
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Nothing short of a shame! How is the American public not raging?  People have been lied to since day 1; and people are paying for it literally with their lives.  How awful is this.

Justice Roberts, you are culpable.  You arrogant politicians and supposed public "servants" have helped yourselves to all the power you can give yourselves.   There is not one among you who have the good sense to be able to know enough to blush at your arrogance.  God help you; no; that's not going to happen because you think you are God.   

People should be charging the White House with signs from sun-up to sun-down.  This arrogant liar should be subject to the same crap he has foisted on the hard working American public.  

Oh, it won't bother those who already get free health care - his base.  This is to insure the illegals he plans to incorporate into his voting pool.  These are truly evil people
Nov 4, 2013 7:59PM
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A person or the family of a person with serious medical issues shouldn't also be burdened with the insanity that was or is health insurance in this country. To saddle someone battling stage 4 cancer with fighting the system (that even an insurance broker can't figure out) is completely disgraceful.

We needed healthcare reform that made things easier and better for people. Not an even more complicated quagmire of crap that can lead to worse care and again, can lead a person and their family to bankruptcy for simply getting sick.

Nov 4, 2013 6:14PM
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This is what happens when you have a government by the greedy corporation for the greedy corporation.  Greedy corporations will be the fall of our once premier country our forefathers built.  We are quickly becoming a 3rd world nation.
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