During a radio interview the day before yesterday, a caller, a surgeon from Ohio, made an incredibly insightful point.  I had just repeated Jane Orient’s pithy quote, “coverage doesn’t mean care,” the idea being that just because you have an insurance card in your wallet doesn’t mean that a physician will see you.  His point:  ”lack of coverage doesn’t mean lack of care.”  

This may seem obvious, but think about what he said and what he does for a living.  He treats patients (as a surgeon!) who have no insurance.  A lot of them.  After the radio interview was over I had this thought.  It’s not that so many folks lack health insurance.  It’s that corporate medicine charges so much for healthcare that insurance seems more necessary than it is.  Ironically, it’s the presence of insurance that renders these high prices.  

Lasik surgery will always be available.  Well, as long as insurance doesn’t get involved.  And obviously, as long as the government doesn’t get involved.  It is the appearance of a third party paying for healthcare, whether “gunvernment” or corporate insurance, that represents the beginning of a price increase.  Is there a place for insurance?  Sure, but based on a casualty model, not unlike that covering your home or car.  

With the “gunvernment” involved in health care, I am going to modify this surgeon’s point:  lack of coverage may mean more access to care.  Those patients paying cash will have better access to healthcare as they will be free and separate from the shortage-causing price controls associated with “exchange” gunvernment plans.  These cash-paying patients will be seeking cash-accepting physicians like the call-in surgeon and looking for facilities like the Surgery Center of Oklahoma.  How the “gunvernment” reacts to this market embarrassment will be very interesting indeed.

G. Keith Smith, M.D.