We call the insurance company and do our part. The company authorizes payment for the surgery in question. We perform the surgery at a price less than half that of the hospital this insurance company tries to force patients to go to. The insurance company doesn’t pay us. Sounds like a great way to make money if you ask me. Collect premiums and don’t pay claims. This is an incredibly successful strategy for making money!
Now the patient is responsible for the bill. The patient is furious as they should be. And they are furious at the insurance company. This hasn’t always been the case. Patient’s used to take their anger out on us but the abuses of certain insurance companies have become so commonplace and people are much better informed so they direct their anger where it belongs. Angry patients are much more effective than collection agencies. We typically get paid soon after the patient throws a fit.
What will happen when the government is the only insurance “company?” There won’t be any concern on the government’s end that they had better handle some patient issue or there will be hell to pay. There won’t be any concern that “we might lose business or a customer.” There won’t be any concern at all.
Is there a place for health insurance? Sure there is. But they should be subject to the same market forces that discipline the rest of us. They have lobbied hard and received many protections from the federal government to free them from that discipline and that is part of the problem with medicine in the US. One way or another, when the government gets involved, they screw things up.
Our prices at the Surgery Center of Oklahoma are lower for patients who either don’t have insurance or save us the trouble of messing with their insurance company. The lack of risk of not getting paid as described above is part of the reason we have such discounted pricing. What business, other than health insurance companies, could conduct business this way and stay in business?
G. Keith Smith, M.D.
