By G. Keith Smith, M.D.:
We’re having a heat wave, and one of my sons facetiously suggested that we turn the air conditioner down to the lowest temperature and open the windows to cool it off outside. I made the comment that this would help with global warming. We all had a good laugh. Then it occurred to me that this was Keynesian economics—on which Washington’s economic policy is now based.
Just as my son’s suggestion discounted the heat contribution of the compressor and fan, Keynes’s economics discounts the damage done by the accumulation of debt and the depreciation of currency. The suggestion is also a clear demonstration of Frederic Bastiat’s analysis of “What is seen and what is not seen.”
Isn’t this also the essence of ObamaCare? What is seen will be many more people with insurance cards/coverage. What will be discounted (not seen) will be the fine print on the card, in invisible ink: “this gives you a right to hope for care,” or “this gives you a right to die in line.”
The physicians’ fees associated with this plan will be low. Really low. So low that no one will willingly see these patients. This is intentional. It brings Medicare-style price-fixing to all.
Fee-fixing below cost is the purpose of the IPAB (Independent Payment Advisory Board). Rationing is the inevitable result. How many cars would a car dealer sell if forced to sell them below his cost? How well-stocked would the grocery store be if the owner were forced to sell the items below cost? The genius of ObamaCare is that the doctor will be blamed.
Will medicine be an exception? Ask a Medicare beneficiary how hard it was to find a doctor in a new town after relocating. Most physicians don’t want to see Medicare or Medicaid patients. Payment is poor, and hassles are intense. Make a mistake on a claim form and you can go to prison for fraud.
Access to care is a problem for the uninsured, but it is worse for those on government plans like Medicare and Medicaid—and ObamaCare will make it worse still. Ask a physician whom he’d rather see, a Medicare patient or someone paying what he can out of pocket. That uninsured individual who was paying for care will now have that money taxed away, and he will be in a line, rather than in the doctor’s office. The money that is taken away from him will go to the government’s cronies who wrote this bill, not for his care.
Will this new UCA (Unaffordable Care Act) guarantee care? No. Many will be denied access to care because they have this new “insurance” card in their billfold. If you are “covered” by an third-party plan that pays a physician less than he is willing to work for, he is not going to see you. If you have nothing, he’ll probably see you out of charity. But if you, by means of UCA, have in effect put a gun to his head and demanded service for less than its market value, he will likely turn you away.
Many insurance cards will be seen. The denial of access and rationing will tend to be discounted or not seen.
Are there people who fall through the cracks and have poor access now? Yes. This is the fault of the government and its prior interventions—tax discrimination against individual purchases of true insurance, for instance. The Supreme Court’s ruling on the UCA represents the institutionalization of “falling through the cracks,” which was previously the exception rather than the rule.
I believe that this bill was meant to create sufficient chaos in the medical marketplace that many will beg the government to ride in on a white horse and rescue us from the crisis it has deliberately provoked in order to move us “forward” to their ultimate goal: a “single payer” (all-government) system.
The government’s compressors and fan are generating a lot of hot air. Look at the unseen effects instead of listening to the false promises. The UCA is to improving medical care as your A/C compressor is to reducing global temperature.
Dr. G. Keith Smith is a board certified anesthesiologist in private practice since 1990. In 1997, he co-founded The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, Oklahoma, owned by 40 of the top physicians and surgeons in central Oklahoma. Dr. Smith serves as the medical director, CEO and managing partner while maintaining an active anesthesia practice.
In 2009, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility, national and even international attention. Many Canadians and uninsured Americans have been treated at his facility, taking advantage of the low and transparent pricing available.
Operation of this free market medical practice, arguably the only one of its kind in the U.S., has gained the endorsement of policymakers and legislators nationally. More and more self-funded insurance plans are taking advantage of Dr. Smith’s pricing model, resulting in significant savings to their employee health plans. His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs for all and improve quality of care.