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<DIV> Major cracks appearing in the foundation of the ACA. </DIV>
<DIV>Big surprise ?</DIV>
<DIV>It will only get worse.</DIV>
<DIV>That is why we need Medicare for All NOW !<BR><BR></DIV><HEADER
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itemprop="headline">Patients Fear Mt. Sinai Will Drop Low-Cost Insurance
Plans</H1>
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forcing some patients to change doctors."
data-title="Patients Fear Mt. Sinai Will Drop Low-Cost Insurance
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data-mediaviewer-caption="Yitzchok Shuster, 52, at his home
in Queens. He is worried that his longtime doctor will no
longer accept his new insurance, which he is locked into
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class=caption itemprop="description"><SPAN class=caption-text>Yitzchok Shuster,
52, at his home in Queens. He is worried that his longtime doctor will no longer
accept his new insurance, which he is locked into until the next open enrollment
period.</SPAN><SPAN
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<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times, serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
id=story-continues-1 class="story-body-text story-content"
itemprop="articleBody" data-total-count="264" data-para-count="264">For four
months, Yitzchok Shuster felt secure in the knowledge that he had signed up for
a<A style="COLOR: rgb(50,104,145); TEXT-DECORATION: underline"
class=meta-classifier
title="Recent and archival health news about health insurance
and managed care."
href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/index.html?inline=nyt-classifier">health
insurance</A><SPAN class=Apple-converted-space> </SPAN>plan on New York’s
Affordable Care Act exchange, and that he was still able to see his longtime
doctor, who was employed by the Mount Sinai Health System.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="570" data-para-count="306">After his insurance took effect in
January, he visited the doctor, Gary Lerner, at his Forest Hills, Queens, office
three or four times with minor ailments. Then at his last visit, three weeks
ago, Mr. Shuster was warned that the practice was planning to drop his plan,
Empire BlueCross BlueShield Pathway.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="862" data-para-count="292">“The girl at the front desk, a real
sweetheart, she told me, Yitzchok, I really don’t want to burst your bubble
because we told you that they would be taking your plan,” Mr. Shuster, 52, said
Thursday. “But we have it from on high that in a month or two, they’re not going
to be.”</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="1194" data-para-count="332">A Mount Sinai<SPAN
class=Apple-converted-space> </SPAN><A
style="COLOR: rgb(50,104,145); TEXT-DECORATION: underline" class=meta-classifier
title="In-depth reference and news articles about Cancer."
href="http://health.nytimes.com/health/guides/disease/cancer/overview.html?inline=nyt-classifier">cancer</A><SPAN
class=Apple-converted-space> </SPAN>patient, who asked to be identified
only as Beth because she was afraid her doctors would resent her if they knew
she was complaining, said she visited her Manhattan doctor, Stacy Suden, on
March 24 without incident. But said she was told on Tuesday that Dr. Suden was
no longer taking her insurance, MetroPlus.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="1526" data-para-count="332">Beth and Mr. Shuster appear to be
among a number of people whose low-cost insurance plans are being dropped by
Mount Sinai doctors. Patients said the changes were especially upsetting because
the open enrollment period for insurance has passed, and federal law does not
allow them to switch plans as a way of keeping their doctors.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="1930" data-para-count="404">It was not clear on Thursday
whether the changes were limited to a few doctors or part of a movement by a
major institution to squeeze out low-paying plans under the Affordable Care Act
or force higher reimbursement rates. Since its merger with the Continuum chain
last year, Mount Sinai has become New York City’s biggest private hospital
system, giving it considerable clout with insurance companies.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="2257" data-para-count="327">Mount Sinai ordered the doctors
not to talk to the press, according to receptionists at both offices, and
messages left for the doctors were not answered. Sid Dinsay, a spokesman for
Mount Sinai, confirmed that Dr. Suden had dropped MetroPlus, and said Dr. Lerner
was still in Empire’s network but “may elect to change.”</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="2432" data-para-count="175">Mr. Dinsay did not respond to
questions about whether the doctors had been told by Mount Sinai to drop the
plans or whether similar decisions had been made across the system.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="2683" data-para-count="251">The state Health Department said
that it could not stop doctors from dropping plans, but that New York State law
requires insurance companies to allow doctors who have dropped plans to permit
patients to continue receiving treatment for up to 90 days.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="3025" data-para-count="342">Despite that law, Beth said Dr.
Suden, her primary care doctor at Beth Israel, part of the Sinai system, had
turned her away. She called MetroPlus, whose agents, she said, first advised her
to go to the emergency room and then sent her to an internist in Chinatown who
did not speak English very well and told her she might have a new cancer.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="3327" data-para-count="302">“The whole point of having an
internist is that she is your internist for more than one month,” Beth said.
“This is a person with medical concerns who can’t afford to be without
insurance. Just somebody who speaks English would be a good start. Maybe
somebody who speaks English and is good.”</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="3494" data-para-count="167">Mr. Shuster said he was told that
the decision to drop his plan would affect about a dozen patients in the group
his doctor belongs to, Mount Sinai Medical Associates.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times, serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
id=story-continues-2 class="story-body-text story-content"
itemprop="articleBody" data-total-count="3842" data-para-count="348">Mr.
Shuster, a rabbi, lawyer and small claims court arbitrator, said he was so
outraged he went to Mount Sinai administrators seeking an explanation. He said
Dr. Arthur Klein, president of the Mount Sinai Health Network, told him that
dropping his plan was part of an effort to force the insurance companies to
negotiate higher reimbursement rates.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="4113" data-para-count="271">“ ‘Rabbi Shuster, you have to
understand we have a right to ensure that our employees at Mount Sinai get a
decent wage,’ ” Mr. Shuster recalled Dr. Klein saying to him. “Then he told
me, ‘We weren’t in favor of Obamacare to begin with.’ ”</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="4157" data-para-count="44">Dr. Klein did not return a call for
comment.</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="4587" data-para-count="430">Mr. Shuster said Dr. Lerner told
him that he would continue treating him at no charge, but Mr. Shuster said he
does not like the idea of accepting charity when he has insurance. “He’s been a
real mensch,” Mr. Shuster said. “But I don’t see it from the hospital’s point of
view. It’s a multibillion-dollar business. I think Mount Sinai has a moral
obligation not to drop any plans until the next enrollment period.”</P>
<P
style="MARGIN: 0px 0px 1em 135px; WIDTH: 540px; FONT-FAMILY: georgia, 'times new roman', times,
serif; MAX-WIDTH: 540px; FONT-WEIGHT: 400"
class="story-body-text story-content" itemprop="articleBody"
data-total-count="4761" data-para-count="174">Officials at MetroPlus and Empire
said they had not yet received word of cancellations, but that doctors are
required to give 60 to 90 days’ notice before dropping a plan.</P><FOOTER
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