Oklahoma Doctors vs. Obamacare
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- เผยแพร่เมื่อ 10 ก.ค. 2024
- Three years ago, Dr. Keith Smith, co-founder and managing partner of the Surgery Center of Oklahoma, took an initiative that would only be considered radical in the health care industry: He posted online a list of prices for 112 common surgical procedures. The 51-year-old Smith, a self-described libertarian, and his business partner, Dr. Steve Lantier, founded the Surgery Center 15 years ago, after they became disillusioned with the way patients were treated at St. Anthony Hospital in Oklahoma City, where the two men worked as anesthesiologists. In 1997, Smith and Lantier bought the shell of a former surgical center with the aim of creating a for-profit facility that could deliver first-rate care at a fraction of what traditional hospitals charge.
The major cause of exploding U.S. heath care costs is the third-party payer system, a text-book concept in which A buys goods or services from B that are paid for by C. Because private insurance companies or the government generally pick up most of the tab for medical services, patients don't have the normal incentive to seek out value.
The Surgery Center's consumer-driven model could become increasingly common as Americans look for alternatives to the traditional health care market-an unintended consequence of Obamacare. Patients may have no choice but to look outside the traditional health care industry in the face of higher costs and reduced access to doctors and hospitals.
For complete text and links, go to reason.com/reasontv/2012/11/15...
Shot, edited, produced and narrated by Jim Epstein.
Approximately 6:45.
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Useless overpaid administrators, board members and commissioners are to blame for the high costs/low care. Same reason why our schools are in trouble. Overpaid superintendents and not enough good teachers.
Crony Socialism makes that happen. As long as X,Y,Z Teacher or X,Y,Z Administrator can lobby/apply/receive government grants and subsidies ( which is really other peoples stolen money through taxes/inflation/fees ) there is 0-accountability for picking off the money tree. Get the government out and open up the market and such "Overpaid and Useless" will not survive and will have to yield to the "Useful/Lower Costing/Better Care" options.
It's governments involvement in Healthcare that supports the reason for there to be overpaid administrators in the first place
government regulations play a huge part into this by design in order to justify single payer. A free market health care system would be way better and cheaper than single payer
The government would never go for this for the U.S. There is no way to steal from it.
I would love an updated version of this video...
Like, how many new surgery centers like this one have been built since 2012?
I would really love to see this in Ohio and refer my aging parents and brother to this system.
This is how Capitalism is supposed to work.
Fiftycalibur "supposed to" and the reality are very different things. Capitalism in it's purest form is nothing but greed and corruption.
Booster Gold Actually this IS how Capitalism works. What reality are you talking about? You're not insisting that we have Capitalism are you? What we have now is Fascism. What we're SUPPOSED to have is a free market. That's what I'm saying.
The reality is that Socialism doesn't work. Neither does Communism. They are maws that end up eating themselves.
Fiftycalibur
Not at all. Capitalism and the free market in it's perfect and purest form are zero regulations, no rules, and the only motive being maximize profit. If anything conservatives who tout the greatness of the purest form of capitalism should be applauding hospitals which outperform the surgical center in pure profit.
Regulations are not the same thing as "control". Here are just a couple of great examples where more regulation would have come in handy, because the company didn't give two shits about who they would affect
www.reuters.com/article/2014/01/23/us-usa-westvirginia-spill-idUSBREA0M03R20140123
www.theguardian.com/environment/2014/jun/05/bp-deepwater-horizon-spill-report-failures-risks
www.bloomberg.com/bw/articles/2013-04-01/more-evidence-that-fracking-causes-earthquakes
isn't it funny. The Deepwater horizon oil spill marred the economy of the Gulf. Caused countless environmental and health damage. If a single individual did something like this it would be called an act of terror. As it stands the company got off with very light fines....and no one is serving jail time. If there were ZERO regulations or laws, then the company would have laughed it off, and just wiped their hands of the incident.
We see throughout the world that highly regulated economies are more successful. For example, in South Korea there are much stricter laws on what companies can call "broadband high speed internet". As a result they have much less expensive and much faster internet than the US. Isn't it funny? The US invented the internet through DARPA, yet we've fallen behind on technology standards compared to most of the developed world who indeed have stricter government regulations to protect consumers and citizens. www.bloomberg.com/slideshow/2013-01-23/top-10-countries-with-the-fastest-internet.html#slide11
And then we have groups like Wall street, who have essentially socialized financial risks while privatizing the benefits.
www.politifact.com/rhode-island/statements/2014/oct/12/allan-fung/allan-fung-claims-wall-street-investors-went-bust-/
the free market doesn't give two shits, and a pure capitalism doesn't benefit the common people. If that were the case Comcast and Time Warner would be providing us blazing fast internet at a lower cost. If that were the case Deepwater Horizon would have never happened because the company would be regulating itself. If this were the case then Wall Street would have not caused the 2007-2008 financial crisis, or the mortgage/housing crisis.
I've given you several examples of failures of a free market in the modern US. These are not insignificant, these examples caused countless suffering and damage.
I support a highly regulated capitalist economy. Capitalists do not deserve the right to play with the livelihood of the common people. If all they care about is profit, then it's cheaper to ignore problems than to fix them. This means safety, environmental, and health protocols. Jailing people who ignore these, and significantly fining the company should they fail to uphold certain standards.
Free market is not code for Anarchist market.
work hard, save money and maybe open up a business one day and get to the top. That's what capitalism is about. You can still do this in Canada, England, Germany, Japan and evrey other country with free healthcare.
We need a state in the union, any state, to fully adopt this approach to healthcare to allow its comparison to single payer healthcare
victor vazquez yeah, I think states can technically repeal Medicaid and Obamacare. It was as late as 1982 when Arizona was the last state to implement Medicaid. I don't know what was before that, I'm guessing private charities and benevolent companies would offer their services for free.
@@alexhopkins2053 - The problem is the federal government taxes ALL state citizens for Medicaid whether the State implements it or not. Which is also the reason no state has "fully adopted" this approach. The federal government has WAY too much power for states to actually have legislative control over much more than roads/bike paths. Its ACTUALLY UN-Constitutional for the federal government to be in the healthcare market at all -- BUT... Good old F.D.R. during the Great Depression stuffed the courts to violate it and its been compulsively violated ever since. The left and even some on the right take the Alexander Hamilton approach to reading the Constitution which is, "It means whatever I want it to mean" and has nothing to do with what it says or was originally written for.
@@tomjoe9477 That's a good point, sir. I've recently been a fan of significantly reducing the taxation at the federal level. Then, if California and New York want to raise taxes and provide universal coverage, nothing is stopping them. All one would have to do is move to that state and get a state ID to be covered. Anyone who wants free market coverage can move to another state. I don't think it will be too long until NY and CA realize how inefficient public health is.
@@ledzeppelin1212 That's the original vision of the founding fathers. It's thirteen experiments in freedom. But this requires two things we have a shortage of 1) it requires humility to admit we don't know. We don't know what the best way is to bring down health care costs, but we have a lot of promising ideas. Let's experiment with them. Find out what works and why it works. Everyone wants Europe's heatlhcare system, but they don't understand why it works if it works. They want free education like Europe. But when I start saying you would have to give up your big NCAA sports franchises and large bloated campuses to have that, they're not so thrilled. Or they just don't believe me. 2) Courage to admit we were wrong.
The healing of our sick health care system.
Kudos to those doctors!! Awesome work!
llg4ever wtf is that icon bruh?
This is where Stefan Molyneux went when he had cancer :O
Go Oklahoma!
I really like the surgery centers and it does save a lot of money. My family likes to come home after an operation to home care by family. The secret is to find a good doctor who uses excellent practices.
This is such good news! I thought I'd have to leave the country to get affordable prices.
Medical care prices rose significantly when insurance companies became the norm. Greed. Plain and simple.
Yes, and they continue to rise every time the gov regulates the insurance companies more.
@@JonCaliber45 Shocker. Almost like government regulation makes things worse.
What we need is less regulation, that way more people can do similar things as the doctors in this video have done.
"Price Honesty" - YES! Way to be transparent with your patients - we love that!
Thank you for stating your case as well as taking the action that you did.
This is the best thing I've seen reason.tv produce in years. Well done, Jim!
Awesome about time someone posted the prices! Thank you
A free market with common sense regulations is all that is needed. In a free market consumers will go to the place where they can get the best care at the best price, which means allowing companies to sell across state lines. Allowing people to contribute to HSA's tax differed would help people pay for their health care needs and increase their options. Also the bureaucratic costs of government would be reduced. And then there is the fact the government miss uses and wastes a lot of money. Also less money would be needed for programs like Medicaid which many doctors won't take and which make up as much as 26% of some states budgets.
Love your videos. Just a note as an editor, when you're describing things with "which is..." there's most likely a more succinct, direct way to express that idea. Helps keep your copy clean/audio smooth and your listener/reader focused.
I don't know if this is feasible, but it would be amazing if you could somehow put out a "documentary length" video on healthcare. These are the perfect videos that show how to fix the health care system.
I've done a lot of work for the healthcare industry. The truth is the gouging and inefficiency is enormous. I applaud OK Doctors for their ingenuity and integrity.
All I can say is HOLY SHIT. We need to get the insurance industry out of the health care business and allow doctors to do as these gentlemen are doing.
Or we could get a bunch of privately owned, smaller clinics like the on in the video being both cheaper and more efficient and have people realise for themselves that they don't need the insurance cartel, all while competition between these smaller companies is going to result in better and cheaper care for patients in the long run.
That's why Capitalism is great. We should have more of that, rather than more Socialist-style centralisation.
This does my heart good. I have a podiatrist cousin there in OK (he's about 7' tall, hard to miss) and I know he's on board.
This is a great video. Please put out more examples of this.
I was getting depressed and extremely horrified reading time's special report 4/4/13 and then I found this vid. It's good to see free market's attempt at fixing these high artificial and collided costs.
As an employer I wish we had a hospital like this one in our city!
This video is really quite important and should show many people why it is that healthcare becomes so expensive in what alot of people claim is a "free market healthcare system." Prices in a free market fall over time, and this exposes the reasons they have not.
A real health care center that help people.
Excellent journalism.
I would love to see a Surgery Center open like this in every state. I'm tried of these blood thrusting doctors, insurance, hospitals and government taking my money that I have WORKED so hard for.
THIS IS THE KEY TO IMPROVING HEALTHCARE!!!!
Absolutely ridiculous.
I live in Europe, and have had Americans tell me just how lucky we are when it comes to the provision of healthcare.
We're not forced by the government to do anything. We simply decided to make sure everyone gets healthcare.
My dentist did that, on a payment plan.
Once he joined a group, Not only was I dropped, but I was notified of full payment or else!
Its not insurance, its providers!
One thing to consider re: superbugs: if an outbreak occurred at a small surgery center, there are fewer people and smaller facilities involved in containment and eradication. Compare that with a large hospital, which may have thousands of patients, providers, and staff in the building, and hundreds of different rooms. On the surface at least, the smaller center would have a much better chance of success.
I can agree with that too.
No party seems to be willing to address one of the roots of the problem, which is that institutions like the AMA and the FDA actually reduce the total supply of available medical care at any given time.
Outstanding! Sending this every where. ;-)
Great Video, I hope more and more places like this open. It's what competion is all about. Then maybe insurance companies can set prices that everyone can afford.
The logic doesn't follow. If taking away the minimum wage results in employers hiring more people, that means there is also more competition and less opportunity for each individual to work their way up. The employer can "throw bodies" at problems as long as space allows.
I have been saying lately, whenever the government starts promising to make something "more affordable", the price goes up. Anyone ever hear of "unintended consequences" or "perverse incentives"?
Hit the nail on the head!
FYI for everyone, the Surgery Center of Oklahoma now has a feature on their homepage where you can click on a body part, see a list of procedures they offer for it, and then get an accurate quote for how much it will cost.
Spread the word about this alternative!
Help support the price war Keith Smith is waging against the cronyist system we're stuck with!
How refreshing! This is how medicine should be!!!!! Cut the insurance middle man, and let the costs of medicine be equal to supply and demand.
Exactly and excellent..
I'm sorry... am I supposed to be grateful that a handful of doctors are FINALLY acting moral?
yeah
Thanks! glad to know I am not the only sane person on the net :)
Where I live, because of universal healthcare, my mom paid around 70 dollars for her surgery. I got hospitalized one day, received IV treatment for 10 hours, a shot of morphine, a bed and food and drinks and I paid nothing for it, they just wished me good luck and sent me home without a bill. When I need antibiotics, I pay around 11$ for them, when I lived in a country with private healthcare, I'd end up paying over 100 for antibiotics.
If the government passed a law requiring all healthcare providers (doctors, dentists, hospitals, etc.) to list their prices for all of their procedures, it could solve the problem of rising healthcare costs tomorrow. Simply require all providers 1) to have a website 2) to have a link on their homepage to a page with a complete price list of their procedures 3) and to provide a brochure with a complete price list of their procedures available at their front desk. Competition will do the rest.
I was given a hard time by insurance companies for charging $75.00 for a PAP smear and brief female physical exam, before 2005. My wife was billed almost a thousand dollars, last year, for the same consultation and PAP smear! They are already raising the prices to beat the coming system!
Have seen a few places like this. What choice do patients have though if their policy through the ACA exchange isn't accepted at one of these concierge facilities?
They don't accept insurance.
Excellent Video! Now I actually have a real-life example to back myself up when I tell people real free market care would be a fraction of the cost of government-corporatist care today. ($5,885 compared to $33,505 is pretty decisive.)
I was once chastised for not using $1,000/ dose antibiotics on a patient, who could get ampicillin (
Every doctor knows that the quality of care for their patients comes first before anything else. It is the core of the profession. People who abuse that physician-patient relationship by making profits and taking autonomy away from doctors should be ashamed of themselves.
Anything that doesn't involve robbing Peter to pay for Paul's care.
Not only is this immoral, it leaves Peter without the money to pay for his own care.
Dr. Smith was interviewed by Lew Rockwell and is a big fan of Mises and Rothbard :)
No, insurance has mad things more expensive by allowing providers to charge higher prices without the patient knowing if they are even getting a good deal or not.
There isn't much correlation between Oklahoma Doctors and Obamacare. This is more a comparison of business models between two different hospitals. This video illustrates that prices in healthcare have skyrocketed in contrast to the pricing in other countries. The ACA has little to do with the already insane prices the healthcare industry gets away with not only in hospitals, but also prescription medication.
Medispawn The A.C.A. is new, so you are correct, but government control of medicine is not new, and there we have a direct relationship with the rapid rise in costs and waste.
thanks for this!
As libertarians-- and, particularly, Anarcho-Capitalists-- have said all along: government is the problem, not the solution. The OKSC will exist and help people until government destroys it.
I have high deductible insurance with an HSA - premiums plus HSA funding is about the same as an HMO, but you keep the HSA funds for retirement if you stay healthy. I had a prescription for an MRI, and started shopping around for price. *Every* provider was *stunned* that someone wanted to know the price. They all took a week to get back to me, after apparently having to research the question. The prices ranged from $300 to $1500! HMOs have totally perverse incentives for all parties.
God Bless !!!
Obamacare specifically bans Dr.s from forming their own hospitals: no competition allowed.
"Reason obtained a bill for a procedure that Dr. S performed at Integris in Oct. 2010 called a “complex bilateral sinus procedure,” which helps patients with chronic nasal infections. The bill, which is strictly for the hospital itself and doesn't include Sigmon's or the anesthesiologist's fees, totaled $33,505. When S performs the same procedure at the Surgery Center, the all-inclusive price is $5,885."
Here is my take: the insurance companies/government don't get to choose the cheapest but effective care, the patient does. Both private insurers or a gov insurer will have the same problem.
Southern states should have a healthcare "secession", exemting all patients, Doctors and businesses from all aspects of Obamacare.
They are well within their rights to do so, and this will be a huge step towards pointing out the difference between free market healthcare and federally run bureaucracies.
I think this is more practical than trying to convince 51% of the population to support a certain candidate.
I don't have health insurance, I can't afford it. I had hernia surgery at a not for profit hospital. The bill was $23k. The hospital extended charity to me and reduced the bill. I paid $9k. Had I known about Surgery Centers, I would have flown down there and saved half of that. Health care costs are ridiculous and we are being taken to the cleaners. It is unsustainable and the free market has once again come up with a solution to a problem.
Insurance companies cannot tell hospitals to deny healthcare, what they can tell doctors and hospitals is what they, the insurance companies are willing to pay or not pay for what procedure or medicine the patient may need. It's up to the doctor to convince them that it's necessary. Another thing, the reason why the prices is high is because of regulations and lack of competition due to government interference.
We get health care regardless of whether we've paid a single penny in tax, its called "Human rights"
This is great. I wonder if there's one in my area, Bremen, IN?
Why is common sense so revolutionary? This place sounds like a step in the right direction
I love the hospital's justification for the higher prices.. that is like Honda charging $70,000 for a Civic because other people can't afford a Civic. While the top company officials are all making 6+ figures per year.
Took the words right out of my mouth! hahaha
Fortunately everyone who has attempted to sign up for it have finally realized that "Affordable" Care Act is a misnomer.
Q tip 30 bucks
cotton ball 25 bucks
band aid 95 bucks
Kleenex 10 bucks
That one of the many reasons why healthcare is so expensive in the USA
I think it is good to feel that you can help other people through taxes and also it feel good that you don't have to sell your house, just to pay your medical bill.
It's basic supply and demand. Producers have incentive to supply more at higher prices and less at lower prices, while consumers demand the inverse. Left alone, the free market (i.e. people) will continuously adjust price and supply towards equilibrium. Govt regulations (most notably the ACA) make it such that the producers can (or MUST) crank up their prices while telling consumers that they're paying less and getting more, keeping the market far and away from the natural point of equilibrium.
sounds like the only problem with the plan is that it doesn't account for the blatant greed of the insurance companies.
I'm very sorry to hear that. If we had more free-market competition, instead of these rigid government mandated coverages, two things would happen: more consumer choices, and more charity hospitals (most of the old ones have been put out of business by government mandates). No, companies don't care (they aren't living beings), but so many caring people who want to relieve suffering, provide support, and help people, are driven out of the profession by the government paperwork and liability.
I'm confused as to where having great places like the Surgery Center (and it does sound great) helps the uninsured people without an employer who will pay $3000 for surgery and who don't have nearly that sort of disposable income. There is still a system that needs to be fixed here.
Regarding the free-rider problem, Obamacare expands medicaid. Add the fact that many employers cannot afford to comply with the costs of Obamacare, so they either hire fewer employees or reduce the number of working hours, potentially pushing more people onto medicaid. Open competition lowers costs and raises quality and choices, but there must be price transparency, which cannot exist if the bill is being paid by 3rd parties.
I think this is a good idea - as long as the surgeon doing the surgery is the best at this particular kind of surger in the area and the surgery center is accredited and has a clean record regarding anesthia, infections etc. The person receiving the surgery is the most important person in this equation - not the insurance company or her employer.
This seems like what we need more.
Re-watch the video and pay attention. The woman in the beginning of the video paid $0 dollars for her care. Her employer paid the full amount out of pocket for her because it was cheaper. So to address your concern, "for people earning 40K, either way they don't have that cash on hand." Their employers would be much more likely to cover the full bill out of pocket, or at least 80 to 90% of it..
Hospitals such as the one in this video can help us determine what a fair price is for medical services and can be used as a benchmark for Obamacare. If everyone is insured, thus eliminating the hospitals risk, then there is no reason that costs cant fall.
I wish people would look at the problems with socialising medicine in America before praising the NHS.
I'm a 4th year medical student. This is the type of free market economics business model I want for my pain management practice. I want to give my patients the incentive to buy high deductible insurance for the sake of lowering their annual cost. Routine physicals can be paid with cash, and I'll post a price just for the office visit. And yes, I do plan on utilizing medical marijuana for my pain patients.
Its here to stay, and that's the point . When your wrong , your wrong .
I generally don't hang out with people who think the minimum wage needs to be abolished .
Now we need a way for people to find places like this in their city or town.
It doesn't drive wages down. To attract better workers productivity must rise and wages must also rise accordingly.
Excellent video!
I never understood why hospitals hike up prices because nobody pays them. Maybe if you lowered them and made them a little more affordable more people would pay. I know when I get my hospital bill in the mail I just get overwhelmed.
Thanks deahunt. I'll check it out.
Walt
No company would pay $3 wages for the kinds of jobs we see today. Why do most people make FAR higher wages than that???
If the majority of the system worked like this Oklahoma hospital, costs would be vastly lower. And you can then more easily cover everybody buy just offering a subsidy to the poor for care, rather than forcing everyone to pay inflated costs through employer-provided coverage.
"Benefit society's aree just single payer systems on a small level"
With one VERY important difference: Unlike government monopoly healthcare, they had competitors and thus an incentive to keep costs down and police themselves.
I really would like to know why "Give a bunch of politicians a monopoly over healthcare and cross our fingers it doesn't go to their heads" just gets to win by default with no justification whatsoever.
Why is taxes treated as free when it clearly isn't?
Just wondering if the surgery centre would branch out into selling insurance to cover costs of the surgeries they provide? (that would be even more affordable).
Why would they? Clearly this system in the video in which prices are made public so patients can actually tell how much procedures cost is delivering better results. If anything we should hope more treatment centers like this spring up to give people more options and better service at a lower cost.
this is something we older americans knew - we grew up before health insurance existed - when doctor and hospital bills reflected the ability of ordinary people to pay. the insurance industry distorted that, and skimmed off the top along the way. now the government intends to do the skimming.
We don't die while waiting for treatment, in the US maybe. We are proud of our health system here in Germany, you poor souls can't expect anything, but we can, health care round the clock.
I think what he's getting at is that the this surgery center does not have an emergency room or urgent care clinic - they just do surgery. So they don't have to take a patient without insurance. There's plenty of bloat at traditional insurance places, but this is apples to oranges.
They are charging the proper fees, but they don't take uninsured so they don't have to take a loss on anything. That is the reality of health care here.
"There are no mandated standardized tests in Finland, apart from one exam at the end of students’ senior year in high school. There are no rankings, no comparisons or competition between students, schools or regions. Finland’s schools are publicly funded. Every school has the same national goals and draws from the same pool of university-trained educators. Yet Finland spends about 30 percent less per student than the United States."
Not bad! You just might be on to something!
When did not having insurance mean that you didn't pay your bills at all?
+Paige Duffy Lewis Exactly they still get the bill in the mail.
They pay their deductible
Yes yes yes exactly what I have been saying. I go to Philippines get blood work done cost $6-$10. Here in US it is $3,000.00 and my out of pocket is about $250.00. Yes that is not a type O I said SIX (6) dollars in Philippines for the same blood work.
Hmmm. Interesting. I have a major heart condition, and I HATE needing to have surgery because it is such a burden on us financially...and we have GOOD insurance! I like this approach. I guess time will tell as to how safe and effective these smaller surgery centers are. With the superbugs that are going around big hospitals these days, are the smaller surgery centers doing a BETTER job at keeping them out or under control?