Repeal and Replace? No Thanks, Take 2!

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By: Keith Smith, M.D. http://surgerycenterok.com

The recent failure of an ObamaCare repeal effort in the Republican-controlled U.S. Senate reminds me of a Mark Twain quote: “If voting mattered, they wouldn’t let us do it.” The turncoat senators had either previously auctioned their souls (remaining publicly in favor of repeal), or were moved by the lobbyists’ persuasive abilities after the polls closed. Whenever someone says to me, “The folks in D.C. just don’t get it,” I say, “Oh, no! They get plenty of it!” Those licking their wounds following this repeal betrayal should assiduously avoid the “socialist’s excuse,” namely that “we just need different people in charge, and it will work.” Only the rarest individual is immune from power lust, once exposed. That everything in D.C. is for sale, including the marketplace that would provide for services that would save someone’s life, should be obvious to all but the most naïve.

Writing in January 2016, I was fearful that the Republicans” would repeal and replace” the [Un]affordable Care Act with McConnellCare, in what would have been a cruel lesson in the failure of central planning from the Republican side of the aisle. We are fortunate that they failed to deliver the worst of both worlds/visions. Republicans are no more skilled than Democrats at planning individual’s lives for them. Why was I worried? They couldn’t even pass the skinniest version of repeal!

Laws, with their lengthy, tortuous clauses outlining penalties for non-compliance, serve primarily to interfere with the natural market preferences of cooperating individuals. Government is, after all, that institution with ideas so great that they have to be mandatory. “Repeal and repeal and repeal” is a slogan and course of action I believe many could support.

Don’t mistake me, however, for a defender of the cartel-like medical system in this country, one which largely demonstrates an absence, rather than a failure of market discipline.

Even after witnessing the repeal betrayal, some people may still defend government and the criminal class of individuals who run it. Even many liberty-minded individuals believe the government has a legitimate role in the medical services/products industry. Very likely, not one in ten “conservatives” knows that the primary driver for the expansion of Medicaid is the mercenary class of crony administrators of Medicaid loot. More slop at the Medicaid trough means more loot for them. An embarrassingly small percentage in this inefficient transfer goes to those who truly need help. If the skimming by what Daniel Horowitz calls the “venture socialists” could be removed, the budget of Medicaid would likely be a tiny fraction of what it is.

The Hugo Chavez admirers are emboldened in their cries for complete control, calling their Third-World healthcare vision by the latest poll-approved name: single payer. But Americans are likely not yet sufficiently cowed to submit to Charlie Gard-like death sentences for their children.

And there is some very good news despite the gloom. A powerful remnant has grown in number sufficient to instill market discipline into the exchange between medical buyers and sellers. This exciting and growing medical free market is highlighted by insurance-free practices, the explosive direct primary care movement, and facilities all over the country that now post all-inclusive procedural pricing online.

As I wrote in January 2016: “How about replacing ObamaCare with freedom?… Free from any influence or input from D.C., free market and price-transparent solutions are proliferating all over the U.S., a phenomenon that has ‘good guy’ industry insiders as excited about the future of medicine as they have ever been. These market-based alternatives are predictably bringing higher quality and lower prices to patients, exactly what you would expect from an industry that is beginning to embrace the same market discipline every other industry must endure.”

Since then, many more medical care buyers and sellers have ended their relationship with the healthcare syndicate, thumbing their nose at the D.C. Ayatollahs. An example: the State of Oklahoma (self-funded), for the benefit of their 187,000 employees now relieves these patients of any out-of-pocket expense if they patronize a facility with “revealed” pricing, a move that forecasts a $200 million/year savings when fully implemented. Washington’s response has been to erect barriers to “self-funding,” a predictable, consistent, but despicable move that only benefits their crony industry pals.

The best news is that, thanks to this latest outrageous betrayal, the consent of the governed is dwindling fast. Americans are beginning to perceive the contempt that the elites have for those on whom they would inflict medical care they would never stand for themselves.


G. Keith Smith, MD is a board certified anesthesiologist in private practice since 1990. In 1997, he co-founded The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, Oklahoma, owned by 40 of the top physicians and surgeons in central Oklahoma. Dr. Smith serves as the medical director, CEO and managing partner while maintaining an active anesthesia practice. He is a co-founder of The Free Market Medical Association.

In 2009, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility, national and even international attention. Many Canadians and uninsured Americans have been treated at his facility, taking advantage of the low and transparent pricing available.

Operation of this free market medical practice, arguably the only one of its kind in the U.S., has gained the endorsement of policymakers and legislators nationally. More and more self-funded insurance plans are taking advantage of Dr. Smith’s pricing model, resulting in significant savings to their employee health plans. His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs for all and improve quality of care.

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