Dr. Keith Smith and the FREE Market in Healthcare

The FREE Market in the Healthcare Industry

Interview with Dr. Keith Smith Part I – Surgery Center Of Oklahoma

Mandeville, LA – Exclusive Transcript – “His first appearance here on the Dude Maker Hotline, Dr. Keith Smith, Surgery Center of Oklahoma. Welcome to the program, sir.  Tell me a little bit about the idea behind the Surgery Center of Oklahoma, if you would.”  Check out today’s transcript for the rest…

Begin Mike Church Show Transcript

Mike:  His first appearance here on the Dude Maker Hotline, Dr. Keith Smith, Surgery Center of Oklahoma. Welcome to the program, sir.  How are you?

Dr. Keith Smith:  I’m great.  Thanks for having me.

Mike:  Tell me a little bit about the idea behind the Surgery Center of Oklahoma, if you would.

Dr. Smith:  Dr. Steve Lantier and I are both anesthesiologists.  In 1997, we had figured out that something was seriously wrong in all the hospitals where we worked.  The patients were not treated medically as well, it didn’t seem, as they used to be.  Financially, they were violated many times.  It just didn’t add up.  It didn’t make sense that they were issued the bills that they were for the care they were delivered.  We thought we could endure that for the rest of our careers and complain about it or we could do something about it.  We bought an old, mismanaged corporate surgery center and just decided to do it on our own.  We decided we would do two things very differently.  By then I had come to the conclusion that accepting money from Medicare was basically accepting stolen property because the government didn’t have any money it didn’t first confiscate from someone by force.  We decided we’d never take any government money and that we would be honest in our pricing.

Long story short, the retaliation by the healthcare syndicate here locally, and also nationally, really hurt our business.  There were all sorts of shenanigans with deductibles and co-pays that made it difficult for patients to find our center or to even financially come to our center.  So to expose that scam and to make ourselves more known to the uninsured and the poor, the people who are having to pay their own medical bills, we put our prices online, five years ago this month.  It caused quite a firestorm because we’ve really pulled the veil back on this cartel.  The healthcare system in the United States is a mess, but it’s not a failure of the free market; it’s an absence of the free market.  It works like a Mexican drug cartel where the hospitals and the insurance companies and the other big health corporations, with inclusion of the government, seek to stamp out any sort of competition that creates great pricing and great quality like we see in every other industry.

Mike:  Let me see if I understand this.  I thought that the whole purpose of going to a hospital for some kind of a surgical procedure was so that the insurance company could pay the bill that I would never see and there would never be any negotiation of price.  I’ve never seen a menu at a medical services institute where you could actually pick and choose or evaluate whether you wanted a procedure or not, and then how much it would cost.  So you guys decided to actually publish how much a medical service costs?  You’re acting as though a medical service is some kind of a saleable commodity, doctor.

Dr. Smith:  It is.  Anyone that will tell you that they don’t know their costs is someone who is benefitting from their failure or unwillingness to provide those costs.  All you need to know is the big insurance carriers, those that have worked so hard to make sure that no patients can get to our facility, none of those big insurance carriers want any part of our pricing.  The prices we have online, there are two things you need to know.  It includes everything, the surgeon, anesthesia, and the facility charges.  It’s a sixth, an eight, many times one-tenth of what the local so-called not-for-profit hospital charges for the same thing.

Mike:  I was being facetious with my question.  As I’m hearing you talk, you know what I’m thinking of?  I’m thinking of the author Robin Cook.  I’m thinking of the book Coma.  As I’m thinking of those big hospitals, they’re just farms, farms for profit.  They claim nonprofit but they’re all about profit.  In order to reap the kind of windfalls they have reaped, it seems to me that convincing the public they don’t want to know how much a medical procedure costs has been part of the exercise.  Would you agree with that?

Dr. Smith:  Yeah.  And Coma more accurately describes the state of mind of people in this country that have been brainwashed by that very propaganda.  These hospitals that claim to be going broke because of all of the uninsured that come into their emergency rooms, that was the great lie that, I think more than any other lie, led people to support this (Un)Affordable Care Act.  In front of every one of these emergency rooms, these supposed loss leaders, there’s a crane building on.  Something that people need to understand is there’s a scam within the hospitals, a deal they have with the government.  It’s called Uncompensated Care.  I call it the Uncompensated Care Scam.  Hospitals are rewarded with a rebate at the end of the year by Uncle Sam to the extent that they claim they lost money.  That’s why hospitals charge $100 for an aspirin even though they know they’re going to be paid $5. Then they claim they lost $95.  That helps them maintain the fiction of their not-for-profit status, even though they paid a penny for this aspirin.  Furthermore, that $95 loss goes into a pool that they shoot to Washington, DC and they get a rebate based on the extent to which they claim these fictitious losses.

There are so many scams that are going on.  These hospitals make money even when they don’t make money.  They make money when they lose money.  You see hospitals buying physician practices and buying other hospitals and building new buildings.  Where do they get all this money?  They get all this money because they have a ton of money.  The whole lie, propaganda, it’s unbelievable.  Some of the small hospitals are suffering, but they’re suffering at the hands of the great corporate giants in the big cities.  They’re like an imperialist force that are taking over healthcare.  The federal government and this (Un)Affordable Care Act, the whole purpose was to assist in this great consolidation in healthcare so we have fewer and fewer choices.

Mike:  As you can tell, Dr. Smith is a pioneer of sorts here, even though he really shouldn’t be a pioneer.  You should be in company with Marcus Welby, MD and the great television doctors of the ‘50s and ‘60s who could not have imagined this cartel menagerie that you exist in, right?

Dr. Smith:  Why is it a novelty that I’ve said: Here’s what I do and here’s how much it is.  That gives you an idea of how really sick the healthcare system is.

Mike:  One of the examples that I give to people is, we have a hospital here in a town near where I live.  I’m in the outskirts of New Orleans.  The town is called Slidell.  Slidell Memorial Hospital is not a not-for-profit; it’s a for-profit hospital.  Just as you described, while they’re bellyaching about how broke they are, there’s a crane outside.  They’re building a brand-new 12-story wing, and not only that, they received a $35 million “loan” after Hurricane Katrina so they could reopen their facility and deal with their damage.  Guess what?  Two months ago, the federal government, aided and abetted by Senator Mary Landrieu, forgave the loan so they could get back to being profitable.  All this is going on while the crane is outside building the new wing.

Dr. Smith:  That’s right.  They’re also going into the small towns where the small hospitals are suffering.  They’re walking up to a family doc and saying: Hey, we’ll pay you triple whatever it is you normally make if you will send everything that makes money to the mothership.  Some of these doctors can’t deal with the electronic health records expense and all the other shenanigans that are meant to make them suffer and surrender.  Sure, they’re building a crane in front of the big hospital to deal with all the business they are buying, all the referrals, basically, that they’re buying.  It’s like an imperialist force.  It’s like an invasion from another healthcare country.  They’re taking things over.  They’ve become expert with this poor-mouthing propaganda.

Mike:  The intriguing thing about it, if I go the Surgery Center of Oklahoma website — and it’s an actual hospital.  I don’t mean to be vulgar, doctor, but you can be surgerized here, folks.  Step #1: Learn about the Surgery Center of Oklahoma.  Step #2: Find your surgery price.  Step #3: Give us a call.  It can’t be that easy!  I’ve got to call the insurance company.  I’ve got to call the insurance company’s underwriter.  I’ve got to call all the referring and attending doctors.  Or I could just go to one of these admission sites at one of these larger hospitals and they’ll do all of this for me.  How can it be possible that a patient can make their own deal with a hospital to have a medical procedure?

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Dr. Smith:  It’s actually easier than that.  We’ve got it set up so you can fill in two or three blanks on an email request form and the next thing that happens is a surgeon calls.  The prices are guaranteed.  They’re online.  They’re all-inclusive.  And we’re making money.  We’re treating patients from all over the United States, all 49 states except Hawaii.  People have come to see us as a result of this pricing.  The two states right now that send us the most patients outside of Oklahoma are Alaska and Wisconsin because the grip of the cartel there is so tight that the pricing is just what you’d expect.  It’s just ridiculous.  The first patients that showed up when we put our prices online were Canadians because they’re standing in line.  They’ve got a healthcare card in their wallet but they don’t get any care.  They’re just standing in line.  We have people on waiting lists.  We have women that have been told it’ll take three years before they can see a gynecologist to deal with their painful bleeding.  They need a hysterectomy.  We get them in the next day.  That’s how it works.  That’s how it ought to work.

Mike:  Let me ask you a biting question that’s not sarcastic.  Are you afraid that people that run the Affordable Care Act, Health and Human Services Department, and these larger hospitals are going to find some kind of way to get to you?  Or have they already tried to find a way to get to you?

Dr. Smith:  These thugs have been trying to put us out of business since the day we opened.  The gloves are off.  Our actions have not been the result of fear at any point.  We opened our facility with the local syndicate locked arm in arm declaring to make sure we never succeeded.  We’ve been in this battle for a long time.  I don’t have any idea what the Feds or anybody else will come up with.  What we’re doing, it’s getting such traction that even the government here in Oklahoma is getting onboard.  One of our latest clients that directly contracts with us — there’s this huge, huge part of the healthcare system that falls under the self-funded category.  A business, rather than pay premiums to a big insurance company, they just save that money and pay for their employee healthcare out of operating revenue.  They realize they’re being ripped off by the insurance carriers.  Those people are highly motivated to seek high-quality, affordable care.

Well, our latest client is the largest county government here in Oklahoma, Oklahoma County.  They have thousands of employees and dependents.  They said: Listen, how about we just pay you your website rates and we’ll just deal with you directly?  Then the state government, the Department of Tourism is thinking about promoting us and promoting Oklahoma as a medical tourist destination rather than people going to China or Singapore or Costa Rica for their surgery.  I think if the Feds decide they’re going to attack, they’re going to run into the attorney general.  They’re going to run into state government officials who realize this has been a great thing for the State of Oklahoma as people continue to stream into this state to receive affordable and high-quality healthcare.  We have some players on our side that in the beginning days we have not.  We’ve had so much success and traction with this now, I think it’d be hard to stop.

End Mike Church Show Transcript