'Doc Shock' Reaches the Masses

Bloomberg View

By Megan McArdle — February 06, 2014

In December, I predicted that “doc shock” was going to be a major problem for the U.S. health-care overhaul, as people found out that the narrow networks insurers use to keep premiums low often don’t cover the top-notch doctors you’d like to see if you get really sick.

I reiterated this in my recent Intelligence Squared debate: However much good, sound policy sense narrow networks might make, they are political poison. Regulators and politicians are going to find it very hard to withstand the appeals of constituents who have been restricted to the bargain basement of our nation’s health-care system. I simply don't think they’ll be able to stand it for very long. This is basically what happened to the managed-care revolution that held down cost growth in the mid-1990s -- people in those plans complained bitterly, in their capacity as both voters and employees. A combination of legal and market pressure forced insurers to open up their networks and approve more treatments. And then costs started rising again. As people begin using their Obamacare policies and start running into restrictions, the same sort of pressure will begin to mount.

  • Download PDF