Coverage Isn’t Care: Deductibles and Rationing

Coverage Isn’t Care: Deductibles and Rationing

Hello, Dr. Keith Smith with you, Surgery Center of Oklahoma. Thank you for joining me.

One of the consequences of allowing others to pay for the medical care that we receive is that others are constantly looking for ways to not pay for the care that we receive. Keeping as much money as possible in their own pockets.

Deductibles and rationing. These are two of the primary methods I believe that are used. It’s no surprise to any of you that actually have health insurance, that the deductibles have been going up for years. These deductibles are now so high that they represent barriers to entry. It doesn’t really matter what the cost of care is of the other side of the deductible after all, if you can’t afford the deductible. This is a way to protect those who pay for our care from paying as many claims as they otherwise would.

The other method, rationing is a little trickier. We would not have completely understood this until we owned and controlled our own facility where we could compare what is a physician paid for a procedure vs. the facility. I knew back in the early nineties that I was paid below my cost for many of the anesthetic services I provided, while the hospital was doing very well. This is a form of rationing where a physician is paid so poorly, that they don’t want to see these patients at all. Therefore, access is difficult. That way those who pay for our care keep more money in their pocket and the physician is the bad guy.

These are two methods that I think you should be aware of. I think it’s important to the extent that we all can, we should pay for our own medical care. Allowing others to pay for the care will invariably result in rationing and denial of care.

Thank you for joining me. We’ll see you next time.