Does Health Insurance Equal Health Care?

Ad-page-0I find myself growing frustrated with the ads on television insisting that we contact our state health exchange website and sign up for insurance before the February 15th deadline.  They make it sound like we will be out of luck if we don’t sign up, risking a nasty, unsightly condition.  The theme is basically this:  if you have insurance, you will receive good medical care; if you don’t, you are on your own.  How misleading!  What a waste of taxpayer money!

Just because someone has medical insurance does not necessarily mean that they will have prompt access to quality medical care.  Many of the insurance policies sold are so expensive that people are reluctant to visit the doctor, worried about the additional out-of-pocket costs.  Simply put, a person cannot afford to see the doctor because of the amount they pay toward the monthly insurance premium.  Crowded offices, long waits and short, rushed visits typically await those who decide to finally use their insurance.  The medical experience feels to many like a mill where they are just a number.  Big insurance companies are making out like bandits with this government-mandated program, pushing a dysfunctional medical system that is already strained to the limit.

Don’t get me wrong…I do believe that there is a place for insurance; specifically, to protect against expensive “catastrophes” such as major surgeries, hospitalizations and serious accidents.  These are considered “large-ticket” items that would be very difficult to pay for out of pocket.  Just as we have automobile insurance to pay for the damage and liability from an accident, so lower-cost, higher-deductible “catastrophic” medical insurance should cover the bulk of these major health-care expenses.  However, just as we do not purchase automobile insurance to cover gas, oil and maintenance, so too we should not pay for an expensive medical policy that attempts to cover routine, outpatient medical costs. Instead, it is more cost-effective to pay out-of-pocket for these services, such as through joining a Direct Primary Care practice, where the member is charged a monthly fee for unlimited access to the physician.

Thanks for letting me vent my frustration.  February 15th is right around the corner, and then we won’t have to hear again about purchasing government-mandated insurance until the fall.  I do have some words regarding the penalty to be paid on April 15th for not carrying insurance, but that will be a topic for another blog!

Richard R. Samuel, MD, ABFP

North Idaho Direct Primary Care

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