Why Do People Insist on Making Health Care Equal With Coverage?


Close up of female African American doctor holding patient’s hand

Dr. Keith Smith, co-founder of both the Surgery Center of Oklahoma and, more recently, the Free Market Medical Association, recently published an editorial article on the website for the Association of American Physicians and Surgeons entitled, “‘Coverage’ Isn’t ‘Care.'”

The article explained how people think that having “coverage” for health-related expenses is so all-important, and yet it is often not all it’s cracked up to be.

This really hit home with me AGAIN because so many people make the mistake of using these two terms – “health care” and “coverage” – as equal in everyday language. However, I would have to say that with some people the conflation of the terms “health care” and “health insurance coverage” is quite deliberate. The people I am describing here are trying to convey the impression that unless there is some third party paying for the medical or surgical care we receive, that care will be simply unavailable, unless you are rich. That is simply not true.

Let’s take Massachusetts Senator Elizabeth Warren, for example.

A January 25 article in the Washington Examiner quotes her as saying, “[It is] time for us to go on the offensive on health care.” This comes with proposing “incremental changes” to Obamacare.” She also said, “We [think leftist Democrats] will defend Medicaid and the Affordable Care Act with everything we have. We will defend it, all the way.”

There you have it. By going on the offensive on “health care,” what she means is going on the offensive by enacting more stringent controls on health insurance companies. It is clear that she believes the only way to get “health care” is to have a third party paying for it rather than simple transactions between a doctor and patient. Since Pocahontas (sorry, I just couldn’t resist that one) is on the warpath against insurance companies, her ultimate solution is for the federal government to be the third-party payer, otherwise known as single payer coverage.

Just as a disclaimer, I have no great love for health insurance companies as they exist now. They have somehow managed to position themselves so that people are extremely dependent upon them for every type of medical care they receive – including routine care that could be very inexpensive if so many third parties (including the government) were not involved. The insurance companies have somehow managed to convince a large number of people that to take care of their health, a third party must be involved.

I have written about alternative practices in the past, and I will continue to belabor this option until the majority of Americans understand it, or I croak off, whichever comes first.

One brave new practice that continues to gain traction, and I hope gains even more traction in the U.S., is Direct Primary Care. This is a type of practice that does NOT get involved with third party payers. Instead, patients sign up for a membership with a doctor’s practice and pay a monthly membership fee for a wide range of routine care, including preventative care, and 24/7 access to the doctor by phone or email for health issues that may come up after-hours.

For instance, Ryan Neuhofel, D.O., located in Lawrence, Kansas, has a pricing structure for his DPC practice that only charges $55 per month for adults aged 19-69 years old. His monthly membership for a family of four (two parents and two dependent children, aged 25 under) is $130/month. Any additional dependent children in the family plan only cost $10 each per month.

This monthly fee provides patients with communication (including phone, texting, and emails), clinic visits during regular hours when necessary, annual wellness and prevention planning, some routine labs and tests such as urine dipstick or rapid strep tests,  annual flu shots, leasing of medical equipment such as crutches, and access to wholesale pricing for less routine labs as well as medications and procedures.

When one compares the prices of Dr. Neuhofel, and many DPC physicians like him, with some of the premiums and deductibles I have read about, I would define the DPC as true health care and Obamacare as no health care, especially for the middle class that does not get subsidies for their so-called “coverage.” Many of them are very unhappy with their premiums and deductibles. Insurance premiums may cost as much as $1,700 per month, if not more, and deductibles may be anywhere from $5,000 to $15,000 per year.

When people are already paying $1,700 per month just to be “covered,” and then they have to keep paying for their medical or surgical services until they hit $5,000 or $15,000, that is what I would call junk coverage – it is worth very little.

So the next time you hear all the wails of the left about how people would lose their “health care” if Obamacare were to be repealed, just remember, that many are not necessarily receiving health care, they just have insurance that may or may not pay for the health care needed in a given year.

As far as low-income people are concerned, there are already government programs that are aimed at paying for their medical and surgical needs, and even those are often inferior.

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