What my patients say about Obamacare

Obamacare expanded health insurance to millions, but those patients face shrinking choices of insurers and doctors.
Obamacare expanded health insurance to millions, but those patients face shrinking choices of insurers and doctors. File Photo

As a private practice doctor, I usually try to steer clear of discussing politics with my patients. It’s simply too divisive of a topic, and in order to be effective at my job, I have to build bonds of trust with the people I’m treating.

But this rule is getting harder and harder to follow – especially when my patients are the ones who bring political issues up. In recent months, I’ve seen an outpouring of frustration from the men and women who come through my practice’s front doors.

They’re mostly angry about the same thing: Plummeting choices under the Affordable Care Act. This is true both in South Carolina, where I live, and in North Carolina.

My practice is one of the few in my area that accepts plans under the Affordable Care Act, more commonly known as ObamaCare. This means that patients from around the region come to us for care. No matter where they come from, however, more and more patients have been describing to me their problems finding coverage under the law.

Their problems often start at the beginning: On the ObamaCare online exchange. When South Carolinians trying to purchase a plan visit the website, they’re finding fewer and fewer choices. Last year, there were six health insurers offering coverage under the law. This year, there are two. Even then, nearly two-thirds of South Carolina counties have only a single insurer – meaning that patients have incredibly limited choices.

Then again, that’s what’s facing the entire state next year. As of this moment, only one insurer – Blue Cross Blue Shield – will offer insurance for ObamaCare patients in our state. Those visiting the exchange right now are learning this the hard way. South Carolina is one of only five states facing this sad predicament.

North Carolina is one of the others. Essentially the entire state has only one insurer.

This understandably upsets many patients. They want options – they want the chance to pick the plan that works best for them. Now, more than 200,000 South Carolinians won’t be able to do that. In North Carolina, nearly 550,000 people are affected.

But that’s not the only way patients are losing choices.

Even after people purchase a plan, more often than not they find their choice of physicians is extremely limited. It’s even worse when it comes to specialists such as myself – in my case, many patients have to travel for multiple hours to see me because I’m the only or the closest specialist their ObamaCare plan covers. This specific issue – the long distances patients have to travel – is one of the most frequent concerns I hear.

When patients try to use their coverage they find that they don’t have access to their doctor – or any local doctors, for that matter.

I’m hearing about these problems every week from my patients. All of their stories are different, but all of their concerns are the same. They want the freedom to choose the health care that best fits their individual needs – and under ObamaCare, that’s becoming more difficult, if not impossible.

Of course, these aren’t the only concerns they bring up. Rising premiums and sky-high deductibles often make appearances, too. But choice is far and away the most pressing issue. For my part, I can no longer avoid discussing politics and health care with my patients, because ObamaCare is directly harming their health and well-being.

Butehorn is an otolaryngologist in Spartanburg, S.C. Reach him at