G. Keith Smith, M.D.

Reason Magazine’s long awaited piece on our facility and free market health care is now out.  I think Jim Epstein did a masterful job condensing a complicated topic into a very understandable and powerful piece.  You can view it here.

G. Keith Smith, M.D.

Have you seen this? What do you think?

Here is a link to my interview with “Russia Today” recorded earlier today.  What a great staff they have there.  

G. Keith Smith, M.D.

Professor Robert Higgs toward the end of his brilliant book, “Crisis and Leviathan,” discusses the errors of the renowned social scientist Joseph Schumpeter with regards to his prediction of a socialist U.S.,  post WWII.   Higgs describes a post-war march toward a more mixed economic result, one characterized by a government that gives lip service to private property but whose intense regulation of this private property resembles the fascistic regimes of wartime Italy and Germany.  Higgs faults Schumpeter for clinging to a Marxist model with the bourgeoisie or “business class” on one side and the labor unionists, intellectuals and government bureaucrats on the other.  Consistent with this “two-class theme” Schumpeter portrays those in the business class as the last defenders of capitalism (much like Ayn Rand).  Quoting the brilliant Higgs,”He (Schumpeter) failed to appreciate how much the abandonment of traditional economic liberties over the long run had resulted not from the acquiescence or defeat of businessmen but from their enthusiastic sponsorship.”  Later, “Businessmen have done more than their full share to foster the active regulatory state from its very inception.”  

Examples of medically related businesses that have embraced this fascism are too numerous to list.  Operationally, it is critical to understand that while the political contributions and bribes these medical mercantilists pay are substantial, the loot they later receive dwarfs their “investment.”  The poor-mouthing and complaining about the regulations or new government hoops and hurdles that these medical “businesses” must overcome create the needed distraction, one that deflects attention from the promised future payoff.  Giant hospitals are a prime example of this “business” model.  Being the only medical facilities big enough to deal with the most onerous government curve balls, behind closed doors the administrators of these facilities cry in their champagne as they watch their smaller rivals whither due to these same government curve balls.  

One can only imagine what kind of dough the HIT (health information technology) companies threw down to obtain a government mandate to buy their product.  This is a more blatant and obvious bribery.  The distraction effort took the form of an intense propaganda campaign to convince the public that this HIT emergency was all in the interest of patient safety.  This campaign continues today.

“Businessmen” that have made their millions through government contracts are nothing more than fascists as they essentially lobby for the stolen property to capitalize their “pubic-private” partnership.  As intensely ingrained as these men are in the medical business, their footing is precarious, as the source of their funding is unstable, essentially the product of a robbery.  True and free markets raising their heads out of the medical mud are devastating to even the biggest of the crony’s flagship “businesses” and facilities.  

As more and more physicians and medical facilities display their prices the tactics and true colors of the fascist conglomerates will become more clear.  I believe that this medical industrial complex will fall just like the Berlin Wall, as the unsustainable and unstable business model, embraced in this country for the last few decades, has run its course.  The free market, with its creative destruction,  will once again bring to ruin those who deserve it dearly.  

G. Keith Smith, M.D.

I wrote recently how ironic I found it that those in Washington responsible for the high price and short supply of health care here are the very ones claiming to have the “solutions.”  Actually they could help solve health care cost and availability issues by systematically repealing every single law related to health care passed for the last 60 years.  No “new” programs or schemes will represent anything other than another public sector disruption of the private sector market forces that have been proven in every other industry to result in the best utilization of scarce resources.  

Have you noticed the recent bombardment of news articles on the new “epidemic of obesity.”  Pretty soon we’ll have a War on Obesity.”  Uncle Sam in charge of what we eat.  Can’t wait!  Actually, Uncle Sam already is in control, somewhat of what we eat, with various regulations and subsidies come to think about it.  In fact, since obesity is primarily a problem of the poor and the government feeds most of the poor with their food stamp program, I think it’s fair to say that they caused this epidemic.  I’m sure they’ll stay true to their “cause it then take credit for solving it” strategy here, too.  I can see the materials that will be distributed to school age children now:  a Shetland pony (with a TSA-like food cop saddled on top) named Broccoli, or something like that.  How many billions will be squandered on insanity like this?  

And why is someone else’s obesity my problem?  Articles say all the time that obesity “costs” billions.  It shouldn’t cost me anything unless I’m obese, I’m thinking.   I think that those who believe that everyone’s obesity is everyone’s problem should be referred to as obesity pimps, just as Walter Williams refers to those who make their living exploiting the poor for their own political purposes as “poverty pimps.”    Applying these derogatory labels to the government goons who would control our lives and rob us at every turn helps deny them any degree of legitimacy.

G. Keith Smith, M.D.

I just want to be sure that readers connect the dots between the salary paid to the nun running the Catholic Hospital Association and your hospital bill.  Any Catholic hospital that belongs to this mafia-like organization (that would be virtually all of them) has to pay for membership.  The money that they use to buy this membership came from…well…it came from you, if you were ever a patient at a Catholic hospital.  

How many people have been bankrupted by medical bills from these outfits?  Don’t you think those who have been unnecessarily financially ruined by these so-called “not for profit” hospitals would be troubled by the nun millionaire?

Also keep in mind that the CHA and Catholic Charities receives massive federal funding.  Since we all know that the government has no money that it didn’t first take from us at gunpoint, that means that another source of the funds required to make a nun millionaire came from taxpayers.  

Once again, if you want to know one of the primary reasons health care is so expensive, look no farther than your local “not-for-profit” hospital.  The unholy alliances they have made with the government and certain insurance companies have resulted in a cartel-like model of doing business, nothing resembling a business model disciplined by ruthless market forces.

Thugs like this nun pushing for Obamacare only have enriching their clients in mind. There is no altruism in a habit-less millionaire nun, whose clients make a regular and daily habit of shaking down the sick for money.

Try to remember that her million dollar salary would not be possible were it not for the taxes you pay and the $100 aspirin and $30 Kleenex on your hospital bill.

G. Keith Smith, M.D.

Why am I such a fan of free markets?  Why are most people in the health care business not big fans?  Why are most people in any business not free marketeers?  I think the answer is complicated and simple all at the same time.  I mean by this that there are many reasons, each of which is fairly easy to explain.  Many businessmen start off as free marketeers only to succumb to the help that the “government” can provide.  Why is this?

Fear

Any organization or institution or business has one goal after it comes into being:  staying in business….survival.  When competition rears its unforgiving head, two paths present themselves:  the desire to improve and compete or alternatively the fearful path, one where  the business’s shortcomings will be found irremediable leading to the pursuit of “protection” from this competition.  Enter the politician/legislator.  He/she is all too willing to “sell” protection to this business by bestowing some advantage on the already established yet threatened business, or by hamstringing the upstart such that the threat if not completely eliminated is rendered a manageable threat at best.  Some choose to reject fear of competition.  Fewer choose to reject offers of protection from competitors, a devil’s bargain.  Competition makes us better than we would be on our own and forces us to examine how we value our services in terms of time and price.  If as physicians we take our oaths seriously and consider our patients’ welfare and wellbeing to be  paramount, there is no better check on our hubris and no better quality taskmaster than the free  market and we should welcome the  oversight the market mechanism provides.

Principle

Every man’s concept of justice is different.  In some men’s minds the economic mindset of conquest seems just.  In this view, taking property/goods/services by force with no compensation to the victim is justified by the notion that in the hands of the ordained/brilliant/enlightened this property or these goods/services are better distributed.  For those who value property rights and peace, the philosophy of non-aggression and mutually beneficial exchange dictates our actions.  This transition from a civilization of conquest to one of mutually beneficial exchange is equivalent to the transition from barbarism to modernity.  Fans of free markets embrace this notion of non-aggression and leaving other folks alone and to their own devices, and make their living by providing goods and services which people value enough to engage in voluntary exchange:  their goods/services/wealth/money for another’s…a fair trade, the determination of which is made between the parties involved.  If this seems like common sense, I apologize, for the very notion of non-aggression and mutually beneficial exchange and the subjective determination of value remains an elusive group of economic ideas for many, particularly those with lots of formal education.

Time Preference

Short sighted actors (those with a high time preference) are wanting to “cash in now!”  ”Get it while the getting is good.”  ”Damn the future…take what you can however you can get it.”  Those who accept government money, those who depend on this funding, those who lobby for even more….they have a high time preference.  People who start businesses, the revenue for which comes from a robbed taxpayer, have every reason to lobby for the continual robbery of taxpayers and embrace a very unstable business model, for once the taxpayer resists this robbery either by refusing to pay or refusing to work, the revenue stream is cut off for the beneficiary of this theft.  Those with a low time preference have a more stable business as the budget fights in D.C. and the impending bankruptcy of government at all levels does not represent the threat that it does for the businessman depending on this loot.  I maintain that a low time preference is a pragmatic and stable business philosophy, not unlike the tortoise and the hare.

Envy

“I want what you have” is jealousy.  ”I want what you have but know that I can never have it so I want to destroy it so you can’t have it either” is envy.  Ludwig von Mises wrote a little book entitled “The Anti-Capitalist Mentality.”  I highly recommend it.  He describes how academicians, for instance, become envious of the “haves.”  They figure that they are smarter and have more education than that “stupid car salesman” therefore should make more money.  The concert pianist cannot abide by the riches sent the rock star’s way.  People vote with their dollars.  Rock stars get more “votes” than concert bassoonists, even though the skill, practice and talent necessary to play a bassoon well dwarfs that necessary to perform even the most demanding guitar lick.  Mises says basically, “if you want to make a lot of money, don’t be a bassoonist or harpsochordist.”  The envy that results from this situation leads many to reject rather than embrace the free market.  This is a common thought process amongst those in academia and in the arts, in particular.

If I choose to embrace the free market and the discipline it provides, does that make me better (ethically or morally) than the guy who is lobbying for more and more theft of your wages?  Yes, I think so.  The thief wants your wages without having earned it.  I want to earn your wages and want you to part with your hard-earned money at my surgery center voluntarily.  I also embrace the market out of self interest as I believe it to be more stable long term.  Health related businesses that rely for instance on Medicare funds are inherently unstable as this source of funding is constantly under threat of cuts/bankruptcy.

Not exactly the same thoughts as those who created Obamacare.

G. Keith Smith, M.D.

This blog is reprinted from Dec. 16th, 2011.