Those costs would be in addition to your premiums, deductibles, and co-pays.
That just happened in Arizona, involving the much revered (even by Obama) Mayo Clinic, specifically its Family Medicine Practice in Glendale, AZ. The insurer in this case is the government's Medicare Program:
West Valley Mayo Clinic Nixes Medicare
According to Maggie Mahar, Mayo "is sending a message" ahead of the Senate Finance Committee's final vote on healthcare reform this Tuesday.
Mayo spokeswoman Shelly Plutowski:
"The message is that something has to change with the way we pay we pay for medical services in this country."The something that has to change, from Mayo's perspective, is how little the government pays compared to what Mayo says it costs to provide care. It looks like Mayo's administrators don't like the idea of a government-run public option: they won't be able to negotiate with the government as they do right now with private insurers. Their message to the Senate: "Don't pass legislation with a public option."
It should be a scandal that 3000 people have to suffer (overnight find a doc who accepts Medicare) because Mayo wants to send a message.
This is basic primary care we're talking about, not specialty care. Mayo is saying they can't afford to provide basic care. They can only afford to provide expensive, high-tech specialty care.
Say your child has an earache, perhaps an ear infection. You plan to visit your primary doc. Your insurer says they will pay $x for that visit. Your doc says that isn't enough to cover his costs, he needs $z. So your doc decides not to treat your child unless you come up with $z.
If you can't afford $z, and your insurer says he can't afford $z, and the doc says he can't afford to treat without $z, then $z is too high. Or someone is not telling the truth.