I blog about free markets in medical care and transparent pricing.

 

Beginning of the End for the Health Cartel?

Kelly Carson, writing for Watchdog.org here, praises the leader of Oklahoma County’s group health plan (Jon Wilkerson) for the success of their arrangement with our facility. I thought it might be informative to summarize the nature of our “arrangement” with Oklahoma County. Ready? We provided a list of procedures and prices and said basically, “here is what we do and what we charge for it.” The “contract” is all of two pages, other than the pricing page which is attached.  

We have contracts like this in place with many self-funded companies or through their benefit administrator (third party administrator) now, all of them essentially a handshake type of agreement.  More businesses every day are sending us their employees for various surgeries in the absence of any agreement, knowing that dealing with us fairly guarantees their continued access to our facility and our pricing.  Many times my office feels like a “situation room” where the requests from individual patients and self-funded companies with employees they are trying to help appear on my Outlook faster than I can type in response!  

While this movement is truly radical and transforming in healthcare, more and more facilities are joining this effort, so many now that I predict this will be seen as the normal way of doing business in the healthcare industry very soon.  The momentum is definitely with those of us who are willing to provide (or display!) healthcare pricing.  Soon, even those whose livelihoods are most threatened by honest healthcare pricing will embrace transparency or face the loss of patients and business to those of us who are transparent.  This has already started with false claims of price transparency by many of the large corporate hospitals, not unlike when a legislator claims to be “conservative,” while clearly and openly auctioning off his/her vote to the highest bidder.  Perception is not everything, as these big hospitals are finding out.

While the beauty of the market is demonstrated with the best allocation of resources and the mutually beneficial pricing from true competition, the power of the market is also something to behold, a power that is bringing the health cartel to its knees and will neuter the heavily bribed D.C. power brokers.  To see the corporatist healthcare scam is to end the scam.  Even as a fan and believer in the power of the market, I am amazed at the deflationary effect the posting of prices has had and will continue to have, this price movement serving to shine a very bright light on the scammers.  Needless to say, the hundreds of thousands of dollars saved by Oklahoma County in just the first few months of our “contract” has opened many previously closed eyes to the possibility that “robbery” is too soft a word to describe their past arrangement with the cartel players.  

In a new effort, I am creating video blogs, links to the first of which are below.  I decided to initially focus on a discussion of how the cartel’s scam works.  Many of you following this blog have reblogged and shared my thoughts, opening the eyes of countless individuals to the healthcare scam in this country.  If you have done so, you are truly part of the team that has begun the demise of one of the most corrupt public-private partnerships that has ever existed.  I thank all of you for your support in this effort.

G. Keith Smith, M.D.

www.surgerycenterok.com     and www.marketmedicine.org

Vlog #1   www.youtube.com/watch?v=UKjmcPpb_JY

Vlog #2   www.youtube.com/watch?v=nk_bfQ03pLE

Vlog #3   www.youtube.com/watch?v=y9H0CGgMnAM

Vlog #4   www.youtube.com/watch?v=14llmetQrwM&feature=youtu.be

Vapor Cigarettes and Veiled Medicaid Expansion in Arkansas

Forbes Magazine’s Josh Archambault wrote recently about the trouble the hospitals in Arkansas are having getting their grubby hands on more taxpayer dollars.  You can read it here.  His story centers around how a popular and powerful Republican legislator, the architect of Medicaid expansion in Arkansas, was just crushed in his bid for re-election by an upstart, no-name.  

Now keep in mind that this just-defeated so-called “conservative” didn’t support Medicaid expansion by that name.  He authored an alternative expansion that has come to be known as “Private Option.”  This “Private Option” was merely the theft of the Arkansas taxpayers’ earnings, wrapped up in all manner of free market double-speak and then handed with a bow on it to the usual health care cronies.  The great news is that the people in Arkansas saw this as a fraud in a package, a “pig in a blanket,” if you will.

It is also important to point out that the corporate healthcare cronies didn’t care about the justification or arguments used to deliver more taxpayer money to them.  They just wanted the money.  Unable to secure straight-up Medicaid expansion, they turned to the Republicans who were up to the task of renaming this theft in return for the financial support of the big hospitals among others.  The real money came in when, as Mr. Archambault cleverly states, “legislators publicly traded their votes.”

Permit me to digress for a moment.  The appearance of nicotine by vapor rather than cigarette delivery has unmasked another fraud in a package, a comparison I cannot resist.  Rather than celebrate this new lung-sparing development, state governments are scrambling to regulate and tax the vapor devices.  Is it possible that the rabid anti-smoking campaign provided a justification for an incredibly high tax on cigarettes, a tax which has produced revenue upon which state governments now depend?  No other explanation holds water, for if state bureaucrats really cared about our health they would subsidize the non-burning delivery of nicotine, utilizing this new delivery method to save future cigarette-burned lungs.  Very simply, state budgets can’t stand for people to quit smoking taxed cigarettes unless this revenue is somehow replaced.  The lungs mean little, the money everything.  Similarly, the sick poor were never the intended beneficiary of Arkansas’ Private Option.  The cronies benefitting from this loot always were.

The strategy of creating a weigh station decoy for the Medicaid loot on its way to its normal crony destination didn’t work.  These schemes are actually easy to comprehend if you first identify that someone’s property was taken from them by force and then seek to identify the beneficiary of this theft.  More and more people simply don’t care what the mugger (government) intends to do with their money.  People are focused on the fact that they have been mugged and when they suspect that their “representative” is driving the getaway car for his crony pals, his political career is jeopardized if not finished.

Hats off to the folks in Arkansas who threw this bum out.  Others who followed his corrupt lead are likely to meet the same political fate and deservedly so.  The “state” is likely the most corrupting device ever invented by man and a regular repudiation of those with political power is a healthy thing, indeed.

G. Keith Smith, M.D.

Government Healthcare as a Contract Breech

One of the smartest people I have ever met is a property and contracts lawyer, someone from whom I have gleaned countless and valuable insights over the years.  He has advised me, among other things, to lead a “haggle-free” business life, where bids solicited from vendors are a “one chance” occurrence.  There are no counter offers allowed.  Over the years, this has ensured a good price and a mutually beneficial arrangement all at once at our surgery center.  

He has also taught me what a contract breech looks like and how to think through the extent of damages.  While I do not pretend to understand the tiniest fraction of his trade, I am confident that what I have learned from him has kept me out of hot water many times, particularly relating to business activities at the surgery center. 

“People love to sue insurance companies because many times they deserve it,” he told me once.  Paying insurance premiums to a company offering homeowner’s insurance, for instance, with the understanding that weather damage would be “covered” represents a contract.  Any failure to make good on this “promise” by the insurance company exposes them to accusations of contract breech and fraud.  Collecting premiums and paying no claims is always a moneymaker, until this fraud is exposed.  Health insurance companies and many other types of insurance companies actively engage in practices that minimize or refuse payment of claims, bound only by what they feel they can likely get away with.  I am convinced that this is one reason insurance companies change their names frequently, this practice allowing them to scam the same population, masked by their new name.

What do you do if you live in a country with “single payer” health insurance and realize that you have been scammed, paying premiums (taxes) for many years, only to find out that you have little or no benefit?  You thought you were “covered” for various procedures or treatments only to find out that the treatment for your cancer was essentially in “layaway.”  You can’t sue for damages.  There is no recourse.  There is nowhere to turn, other than to leave the country to purchase healthcare elsewhere.  I am not sure there could be a better argument against single payer than an utter lack of recourse. 

The lack of market competition and the recourse market failure represents, explains the failure of health care delivery in all socialized systems, whether in Canada or the VA system here, or the new Obamacare silliness.  Canadians have to buy health insurance, basically by paying taxes earmarked for the small amount of health care placed in layaway on their behalf.  People in the U.S. now must buy “insurance” or pay a penalty.  Worse, employers must provide insurance to their employees or pay a penalty.  What’s the difference?  The “purchases” in single payer countries and those in the U.S. now both occur at gunpoint, both mandated payments to those in power or connected to power.

Before you lay the blame for Obamacare on all of the stupid people in Washington, consider for a moment, Rothbard’s historical method.  The brilliant “Austrian” economist began every investigation of historical events with “cui bono,” or “who benefits.”  In short, he identified the beneficiaries of a law or government intrusion and assumed the worst of them, rarely if ever mistaken in his provocative conclusions. 

Similarly, I maintain that to truly understand the purpose of Obamacare one must, I believe, start with the end result, that is, lots of very identifiable people and businesses getting rich because of this “law.” In the private sector, a scam like Obamacare would of course be considered criminal, at least a breech of contract. 

The victims of single payer healthcare, VA healthcare and increasingly, Obamacare, are learning these lessons in the hardest ways imaginable.  The most difficult task it seems is to come to believe that the gang in D.C. knows exactly what they are doing and doesn’t care about broken promises or lives. 

At the Surgery Center of Oklahoma we plan to continue trumpeting the power and the beauty of the market at work in health care, hoping that our facility’s success and wonderful patient success stories will more quickly bring an end to the idea that the provision of health care should be entrusted to the corrupt state.

G. Keith Smith, M.D.

For more information about free market health care visit:

www.surgerycenterok.com

www.marketmedicine.org

 

Reading List

I have been asked many times to pass on a reading list to readers of this blog.  I have resisted because I find that I am most affected by what I have most recently read many times.  While the older I get, the more uncommonly I encounter a jaw-dropping new perspective or idea, I still enjoy this wonderful experience from time to time.  Not surprisingly, the most challenging and compelling works are often times those written long ago.  

Now that I have discounted any reading list I would provide, here are two suggestions, two brief works I read every year about this time of year, representative of writings that have formed my way of thinking about things.  Rothbard’s Anatomy of the State, found here, is one of the most compelling perspectives on the true nature of government ever written in my opinion.  

Professor Robert Higgs’ “If Men Were Angels:  The Basic Analytics of the State Versus Self-Government,” found here, is also worth reviewing from time to time.  I find both of these writings to bring me perspective and focus, something easy to lose in the world in which we all live.  If you haven’t read either of these works and you are ready to entertain the thoughts of two of the most compelling and provocative writers I have encountered, you are in for a treat.

G. Keith Smith, M.D.

For more information about free market healthcare visit:

www.surgerycenterok.com

www.marketmedicine.org

My Interview with Albert Lu’s “Power and Market Report”

Here is my half hour interview with Albert Lu, an intensely well-informed disciple of the Austrian School of economics.  I thoroughly enjoyed visiting with him and hope you enjoy it, as well.

G. Keith Smith, M.D.

For more information about free market health care, visit:

www.surgerycenterok.com

www.marketmedicine.org

William Jasper Skewers Corporate Health Cronies with his Pen

In a related article, The New American’s William Jasper exposes the health industry’s cronyism, all enabled by the federal government.  You can read it here.  This is courageous, “take no prisoners” journalism.  

Dr. Lantier and I thoroughly enjoyed Mr. Jasper’s visit to our facility.  We were both amazed at what he knew about us before he arrived.  In case you missed the video interview I did with Mr. Jasper while he was here, you can view it here.

Once again, our thanks to The New American and William Jasper for their part in spreading the word about the free market cure for the cartelized U.S. healthcare scam.  

G. Keith Smith, M.D.

For more information about free market health care visit:

www.surgerycenterok.com

www.marketmedicine.org

New American’s William Jasper Captures the Essence of SCO

William Jasper, senior editor of The New American Magazine, has combined his gift as a writer with his recently obtained knowledge about what we are doing at the Surgery Center of Oklahoma.  The result is one of the finest articles I have ever read.  You can read it here.

No other journalistic work has connected the dots better between our passion for the principles of the free market and the real difference we are making in people’s lives.  Even though I have a ring side seat to all that is happening here, I was moved as I read his article.  

Thank you to Mr. Jasper and The New American for this great article and for assisting us in spreading the word about the applicability of market discipline in the health care industry.  

G. Keith Smith, M.D.

For more information about free market healthcare visit:

www.surgerycenterok.com

www.marketmedicine.org

Hidden Costs

The Oklahoma Health Care Authority (OHCA) which administers Medicaid in the state of Oklahoma and facing anticipated budget shortfalls, has proposed an increase in the copays Medicaid beneficiaries should pay for medicines and doctor visits.  Before you give too much credit to OHCA for this politically incorrect move, understand that no one has screamed louder for the Obamacare expansion of Medicaid than this government agency, an expansion rejected so far here in Oklahoma.  Copays for medicines could increase from 65 cents to $4.  For office visits?  From $3 to $4.  Statists are screaming, hanging the usual crepe.

A devastating editorial in The Oklahoman about the statist’s reaction caught my attention and here are my random thoughts.  Referring to the copay burden individuals with private insurance endure, the editorial had this to say:

"Keep in mind, those citizens (with private insurance) are forking over their hard-earned money for a copayment and at least a share of their premium  That latter expense is one Medicaid patients don’t face." 

While this editorial is hard hitting, the writer has left something out, hasn’t he?  Namely that the citizens with private insurance are also paying the premiums for the Medicaid beneficiaries.  Come to think of it, these same citizens are paying the largest share of the premiums for Medicare beneficiaries.  Take a look at the FICA taxes deducted from any paycheck and see this for what it really is, the health insurance premium for someone you don’t know and many times, someone who can better afford it than you.

Governments work very hard to hide costs making the connection of the dots more difficult for the average citizen.  Devaluing the currency is a way for the state to spend the money in your wallet without actually physically taking it from you.  The true cost to the beneficiary of Medicare or Medicaid is blurred by the various tax subsidies stolen from others.  Corporate welfare subsidies at all levels of government are mainstream and commonplace these days, hiding the true cost of doing business, always to the advantage of those plugged in to this trough.  

In my opinion, the hidden costs of health care can only be addressed with transparent pricing.  Value cannot otherwise be ascertained as no comparison between choices is possible without transparent pricing.  Crony players in the health care industry, just like the apparatchiks of the state, have made out like bandits by leveraging their knowledge of the pricing games and manipulating the system to their advantage.  Corporate health care has taken the lead of their pals in government, concocting countless numbers of hidden schemes to rob the sick.

(My favorite recent discovery is when an insurance carrier deducts one amount from a self-funded employer’s health account and remits a different (smaller) amount to the folks providing the care, keeping the spread (basically repricing).  Employers suspecting this is the case and demanding to see their “claims data” are told this is proprietary per the terms of the contract.  Hidden from the employer is a source of massive profits for the carriers doing this.) 

Imagine the reaction if a taxpayer was honestly informed in this way:

"Here is what you pay for your health insurance coverage for yourself and here is what you pay for the coverage for other people you don’t even know."  The real reason these numbers are hidden is fear.  If people can ever quantify the extent to which their government (at all levels) and their cronies have fleeced them to line the pockets of others, the fear of those in control will truly be something to behold.

G. Keith Smith, M.D. 

For more information about free market health care visit:

www.surgerycenterok.com

www.marketmedicine.org

Change is in the air

Here is an article I recently wrote for the Free Market Medical Association (FMMA) that I thought many of you would find interesting.  Since writing this only a few days ago the membership demand from those seeking free market minded physicians and facilities continues to outpace those providing the services being sought.  I find it interesting that now that a very few of us have demonstrated that transparent and guaranteed pricing is a possibility, those demanding this are rushing the gates faster than those who could cater to this demand are stepping forward.  

Stay tuned.  That is all about to change.

G. Keith Smith, M.D.

Forbes’ Glen Tullman Compares Us to Apple and Uber

Glen Tullman, writing for Forbes Magazine, compares the innovation of our price posting to that of the companies, Apple and Uber here.  Here is a quote from the article, one that will give you an idea of the author’s thoughts about what we are doing:

"If you do one thing after reading this article, find your way to the Surgery Center of Oklahoma’swebsite. Considered by many to be one of the highest-quality operations in Oklahoma, they allow visitors to click on any body part and see the costs for surgery, which is almost always dramatically less than hospital prices.” 

Groups to whom I speak regularly ask me in what ways we have been attacked (or anticipate being attacked) by the health cartel.  Regarding this point, Mr. Tullman provides an optimistic outlook, one with which I agree, placing his faith in the power of the consumer over that of the health cronies and their hired guns in government at all levels.  

I love Rothbard’s characterization of the free market as both powerful and beautiful.  If Mr. Tullman is right, consumer power, until now largely neglected in health care, will serve as our Kevlar when those who reject the discipline of the market attack those of us who have embraced it.

G. Keith Smith, M.D.

For more information about free market health care visit:

www.surgerycenterok.com    and

www.marketmedicine.org