An open letter to CareNet and Toledo’s leaders and philanthropists.

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An open letter to Carenet, ProMedica, Mercy, United Way, The Stranahan Foundation, Susan G. Komen for the Cure, Lucas County Commissioners, University of Toledo, Buckeye Cable System, UAW, The Kroger Company, the Andersons, the Mancinis, the Blacks, the Blocks, the Petersons, Toledo Community Foundation, Ms. Barbara Steele, and all the other generous Toledo’s civic-minded families, leaders and philanthropists, too many to list,

Did you know that 60-70% of Toledoans receive Medicaid or Medicare? That’s a lot of people.  And  many other people in Toledo have incomes that are between 139% and 400% of the Federal Poverty Level. The price of health insurance has gone up so much – doubling and tripling in just seven years – most people cannot afford $25k per year average premium for a family of four. Even if the median household income in Ohio is $49k – they just can’t manage it. They’ve got kids, they’ve got rent, they’ve got food and car expenses too. Don’t you wonder why health insurance costs more than half of most Americans’ incomes? These people need the tax credit subsidy of the Affordable Care Act. (Until this country can come up with a better idea.)

But, the affordable health plans available to them on the Marketplace include hardly any Toledo doctors accepting the affordable insurance and/or that are accepting new patients, even when they are listed all over the internet as accepting new patients.

There are perhaps 200 insurance plans marketed to Toledoans. But 90% of them are priced way out of the stratosphere for most of Toledo, even for Toledo’s ever-shrinking upper-middle class. (Remember that quaint term, “the upper-middle class?” we don’t hear it much any more in Toledo.)

It’s shocking, but it is true. that the affordable plans, the ones that are affordable according to the ACA law, are few, have extremely limited networks, if in fact any of the doctors listed on the plans’ networks even do accept new patients.

The price we are forced to pay for these far inferior plans, as consumers, as taxpayers, is actually double what we used to pay for our quality Medical Mutual PPO national-network health insurance just three years ago. Double the price! And they are being sold to lower-income Toledoans with no regard to the veracity of the network, with no respect for the quality of care that lower-income Toledoans deserve — after all — it sure is expensive!

How can we pay the insurance industry twice the price of a quality policy that actually costs half as much three years ago, and not get any value out of it? It just doesn’t make sense.

Toledo used to be an industrial town where glass was its biggest industry. Now the biggest industry is ProMedica; it is building new additions at the Toledo Hospital, a big ambulatory medical center in Sylvania, new headquarters and the renovation of the historic steam plant on the riverfront in downtown Toledo. It’s all so wonderful for Toledoans — an infusion of city income tax dollars from the workers, and I’m sure there are other benefits.

Our hospitals and health systems are here in Toledo, and obviously their purpose is to serve Toledo. To serve Toledo within the economics of the Toledo market, not at Beverly Hills prices, that maybe only .1% of Toledoans can really afford. But those 243 people go elsewhere for serious healthcare.

Why don’t more doctors at ProMedica accept the affordable health insurance, like Ambetter, HealthSpan or CareSource? Is it because these insurance companies don’t pay? Doesn’t a new insurance that costs two times as much as a similar but quality insurance cost three years ago have the same reimbursement rate as a long-standing insurance plan? If not, please let us know.

That would be a good start.

200 health insurance plans (just guessing), a consolidated health system in Toledo, yet each doctor is responsible for signing contracts with so many different health insurances, and gee-wiz, it is so much trouble to keep up with their internet profiles. Maybe ProMedica should simplify this for all of their doctors and simply accept all 200 insurances, which should be paying all the same after all, and ProMedica, etc. like Mercy and Toledo Clinic, should be responsible for keeping up internet profiles of doctors in their ever-growing universe. Or maybe advocate for some health insurance that is more universal if they think this system is too difficult. Because we the citizens of Toledo, Ohio, find it very difficult too.
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