Health Insurance Doesn’t Guarantee Access to Care

“What does it mean,” Dr. Keith Smith, CEO and managing partner of the Surgery Center of Oklahoma (SCO), asked in a video blog, “when a patient from Canada flies to Oklahoma City and has surgery here in our facility?”

“What does it mean when a patient has one of these new Obamacare cards in their wallet, but their out-of-pocket experience here at the Surgery Center of Oklahoma is better for them than if they actually used that Obamacare benefit?” he further inquired.

Smith then answered his own questions. Patients who prefer to pay cash for their surgery despite having health insurance — in Canada, through the government’s single-payer program; in the United States, through ObamaCare’s private-but-highly-subsidized exchange plans — “have coverage, but they really don’t have access to care.”

Canadians, for instance, are often subjected to long waits for procedures. According to Forbes, “In 2013, Canadians, on average, faced a four and a half month wait for medically necessary treatment after referral by a general practitioner.” The wait for basic diagnostic imaging such as an MRI stretched into weeks if not months. And these long lag times come at a price: the patient’s physical and mental health. Productivity is lost, health often deteriorates, and sometimes death results.

Americans, meanwhile, are learning that ObamaCare exchange coverage is often expensive, has high deductibles, and features a very narrow network of healthcare providers. Those covered under such plans are likely to have to wait to be seen by a physician and to pay a significant portion of their healthcare costs out of pocket. Those who obtained coverage under ObamaCare’s Medicaid expansion are in even worse shape because fewer and fewer doctors are willing to treat Medicaid patients given that program’s parsimonious payments.