Aaron Carroll reminds us that everybody rations:
I work at Indiana University, and after some mergers are finalized, I’ll be part of Indiana University Health. But that’s irrelevant to this story. What you’re seeing is a product of cost control in the private insurance market. Sure, you might not like government regulations or price setting as a means to lower spending. But the tools available to the private market aren’t magical. They can ration, or deny you expensive care. They can use cost-sharing to try and get you not to obtain care. Or, they can contract with certain networks of physicians, getting better deals with them, and making it much more expensive for you to see a doctor they don’t favor.
If the doctor you like is out of that network, you’re out of luck.
I can’t stress this enough – this is private insurance. Ironically, the insurance program with the largest network in the country is likely Medicare. You can go to almost any hospital and get care, without worrying if you’re “in network”. I bet more physicians nationwide accept Medicare than almost any other insurance product.
Whenever conservative politicians raise the specter of rationing by public insurers, remember that this is a feature of the existing private insurance system as well as the public insurance system. There’s a big political advocacy effort underway to convince you that Medicaid insurance is worse than being uninsured but the GAO found it’s basically no worse than private insurance. The more we expand public insurance, the more doctors will have to accept the lower prices we want to pay.