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What Free Market Health Care Would Actually Look Like


Muda69

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https://reason.com/2021/06/19/what-free-market-health-care-would-actually-look-like/

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If you have health insurance but no primary care physician, the process for getting a physical can be a bit complicated. Whether or not you get your health insurance through an employer, you'll probably have to find a practice in your area that is in your network. Then you'll have to find out if it's accepting new patients. You may have to wait months until the office will let you come in for a physical. You'll have to figure out if you're responsible for a co-pay. Even after the visit, you may need to cover the additional cost of any blood work or other tests, and you probably can't figure out how much you'll be billed for that ahead of time. At some point, you'll also have to decide whether it's worth the trouble to set up a tax-advantaged account to cover the unpredictable costs of this visit or any future ones.

 

Or you could just find a direct primary care doctor who's accepting new patients and pay a flat monthly fee that covers all your in-office services and tests. If you need an out-of-office test or a prescription, the practice may also give you access to steep discounts compared to what it would cost with insurance.

There are currently more than 1,400 direct primary care practices operating in 49 states. Among them are doctors Lee Gross and William Crouch at Epiphany Health Direct Primary Care in North Port, Florida. They charge just $75 a month for an adult, $30 per month for one child, and $15 a month for each additional child. After that, nothing more is owed for services provided in the office—no health insurance necessary. In January, Reason's John Osterhoudt visited Epiphany and spoke with Gross about what free market health care should, and can, look like.

Reason: What is primary care at a fundamental level?

Gross: Primary care in its most fundamental level is the most basic aspect of health care delivery in the world. It is where most people interact with the health care delivery system. It's where you do your preventative maintenance, where you go for respiratory infections, where you manage your high blood pressure, your diabetes. About 85 percent of all health care delivery in the country can be managed at a primary care level, so that is really the bulk of health care delivery in our country.

 

What is it that you and Dr. Crouch do at Epiphany, and how is it different from the traditional fee-for-service, insurance-based model?

When I was in the fee-for-service system, I felt like I was playing a game of Whac-A-Mole with Medicare. We had to find ways of doing as much stuff to as many people as possible to generate as much revenue just to pay for the computer systems that I needed to bill Medicare so that I could get paid. So I'd have to get more people and I'd have to hire more staff, and then I'd have to see more patients to pay more staff, and it was a snowball. Every time I found a way to generate revenue and prop up this monstrosity that we were required to build, Medicare would knock the knees out from under us and take away that revenue source. Eventually we just said, "No more."

 

The name of our practice is Epiphany Health, and that's a very strange name for a health care company. But we did have an epiphany, and the epiphany was "Why are we inserting so many people at the primary care level between the doctor and the patient? Why are we insuring primary care?" The more people that you insert between the doctor and patient, the more expensive it gets, the more cumbersome it gets, the more impersonal it gets. We had our epiphany about 11 years ago: Let's kick the middlemen out of this relationship. Let's have a direct relationship between the doctor and the patient, and at that point we created one of the first direct primary care practices in the country.

Now, at the time we were doing this, there were many other practices simultaneously working on this model. It has since come to be known nationally as "direct primary care," but essentially it's a membership-based primary care program. Instead of a fee for service, instead of a charge for every time the doctor touches the patient, you have a flat subscription fee, much like Netflix. Once you pay that membership fee to your primary care physician, all the services that are provided in the doctor's office are done so at no additional charge. If I see you 10 times in a month to manage a complex condition, it doesn't cost you any more, and I don't bill your insurance for every one of those interactions.

When we opened our practice in 2011, the first thing we saw was uninsured patients coming to our practice from all over Florida. We're in Southwest Florida, this is not the Mayo Clinic or the Cleveland Clinic, but patients were driving hours to access care because they could afford it. They couldn't afford an insurance policy, but they certainly could afford health care in the manner that we were providing it.

....

Ideally, what should insurance pay for? 

If I were to be able to design the perfect marriage between direct primary care and the coverage that's needed for the what-ifs, the major catastrophes, I would have some high-ceiling, bare-bones policy, much like your homeowners insurance. You need your homeowners insurance if your house burns down. You don't need it to mow the lawn. Let's make the routine stuff affordable, and let's have some safety net for "What if I get cancer? What if I have a heart attack and need a bypass surgery?" That's what the insurance is ideally good for. Unfortunately, Obamacare basically made those plans -illegal.

....

I saw someone claim on Twitter recently that the American health care system is run by "the ghost of Ayn Rand." Someone might say, "Look at these private insurance companies in this capitalist system making health care so expensive." Why is that not true, and how does the direct primary care model align better with free market principles? 

The myth is that profit by its mere definition does not belong in the American health care system, and it's evil, and it creates perverse incentives. While there certainly are perverse incentives in all these systems, the key to making that profit work is, again, the elimination of that third party in the middle of that profit which just drives up cost but adds no value.

Direct primary care is about as close to a free market in health care as you've ever seen in our country. People say, "We tried the free market. It didn't work. That's why we need the government to take over with a single-payer health care system." We have never had a true marketplace in health care. We have competition, but we have competition in a price-fixed system, with very opaque prices. While I was trained in Cleveland, we had the Cleveland Clinic and University Hospitals Cleveland Medical Center, two massive institutions right across the street from one another that competed aggressively to do lots of very expensive things to lots of people. But they had no incentive to compete on price. They might compete on quality, they might compete on service, but they never competed on price.

The first time I went to Washington and made a presentation on direct primary care, I gave it to a group of physicians, and after I gave my presentation on our practice and what we were doing, a doctor raised his hand and said, "You are charging $80 a month. What happens if some doctor sets up right next door to you and charges $40 a month?" I said, "That's an excellent question, because if the first question out of the audience is 'What are we going to do when we bring down the price of health care?' we're onto something. Because that question has never been asked in the American health care system ever."

I said, "That doctor and I are going to have to compete on price and quality, and I'm going to have to justify why my price is twice as much. Maybe I provide better service. Maybe I'm just better trained, have better credentials, or have more experience. But something tangible is going to have to justify that, or I'm going to have to lower my prices to compete, or I'm going to lose patients to the person down the street." Value is determined by the user of the services, which is the patient. It's not the value as determined by how many codes I can send to the third party to justify why I'm doing the things that I'm doing and that I can get certain lab results out of you or certain blood pressure readings out of you to prove that I'm a good doctor. I'm going to prove I'm a good doctor to you by how you value my services.

So if we're looking for the ideal health care system, we want to see three pillars. We want to see lower cost, better quality, and more choices. You cannot have all three of those in a government-run system. You can only have those in a free market capitalist system.

The wave of the future.  I'm all in.

 

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Death; free market healthcare would look like death. 

I answered the question for you. 

23 minutes ago, Muda69 said:

and pay a flat monthly fee that covers all your in-office services and tests

This is just a health insurance plan. 

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50 minutes ago, DanteEstonia said:

Death; free market healthcare would look like death. 

Please elaborate.

 

50 minutes ago, DanteEstonia said:

This is just a health insurance plan. 

That is one way to look at it, but without all the complications from traditional government and private insurance companies.

 

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Why Aren't There More Free Market Surgery Centers and Clinics?

https://mises.org/wire/why-arent-there-more-free-market-surgery-centers-and-clinics

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[This is a transcript of a talk given June 17, 2021, at the Mises Institute’s Medical Freedom Summit in Salem, New Hampshire.]

On behalf of everyone at the Surgery Center of Oklahoma and the Free Market Medical Association, thank you for the opportunity to speak to you today.

Just over twenty-four years ago the operation of the Surgery Center of Oklahoma began with a simple mission: deliver the highest quality of care at a reasonable and disclosed price. We fancied ourselves free marketeers, not aware of how far we had yet to go to accurately claim this title. Our mission was the opposite mission of the hospitals where we had previously worked. Then, as now, hospitals are focused almost exclusively on revenue, many times inflicting surprise and bankrupting bills on their victims. As physicians working in these hospital systems, we were unwitting accessories to these crimes. We intended to operate our facility differently, intending to serve as both medical and financial advocates for our patients. The Surgery Center of Oklahoma is now viewed as a model of medical services delivered free market style partly because of this simple mission, but more recently due to posting all-inclusive pricing online and the effects this move has imposed on the medical and surgical market. I’d like to begin by describing the state of the industry at the time we decided to walk away from it.

I’d become convinced by the early 1990s that government had no money it had not first stolen and to accept government payment was to receive stolen property. In 1993, three years after I started my anesthesia practice, I therefore stopped accepting government money and stopped filing Medicare claims. I treated Medicare patients outside of the Medicare scheme and usually free of charge. When I began practicing in 1990, Medicare paid me about $1,100 for the anesthesia services required for an open-heart surgery. In 1992, this payment was cut in half. A year later that amount was cut in half. The last two payments I received from Medicare were as follows: $285 for a six-hour cardiac anesthetic and $78 for the anesthesia services required for a knee replacement. These fees had been imposed through a mechanism referred to as the resource-based relative value scale, more appropriately called the Rosemary’s baby of healthcare. According to the folks at Harvard who gave birth to this creature, every physician service had a price and they knew what those prices were. I had read enough about economics by this time to know that this imposed pricing was not personal, as punishing as it seemed. Prices are signals, after all, and Medicare was sending me a signal regarding what they thought the service I provided was worth, or they meant to intentionally cull the ranks. I felt obligated to respond with a rational signal of my own and as I’ve mentioned, I quit participating in their scheme. I still had much to learn about pricing, but I did notice that underpriced services became scarce and overpriced services became abundant.

Private insurance carriers seized on the fear created by this deep slashing of physician fees, drastically reducing the amounts they paid to physicians. Hospitals, not about to allow a crisis to go to waste, cashed in on their opportunity to cheaply purchase physician practices. To legitimize their bold strategy, hospitals cranked up their propaganda machine, proclaiming loudly then as they do now that they were going broke. Hospitals flush with cash even laid off critical nursing staff to justify this narrative. I’ve always found it interesting that hospital emergency rooms, the supposed primary source of their financial woes, always seem to have a building crane out front. Who builds on to their loss leader? And yet the lack of paying patients in the emergency room was part of the poor-mouthing narrative in the early ’90s, just as it was during the debates leading up to the un-Affordable Care Act.

To further bolster this bankrupt-hospital narrative, physicians and surgeons were told there was no money to buy the equipment and supplies they needed. It was becoming increasingly obvious that it was time to get out. I had no desire to be controlled by the rising administrator class. The only choice for me was to find a way to practice outside of the hospital environment, no longer an accessory to the hospital’s financial crimes against patients.

The Golden Rule and the concept of mutually beneficial exchange is a large part of what drove me to become a physician. While the vast majority of physicians embrace honest and mutually beneficial exchange, it turns out that the vast majority of hospitals do not. Hospital commerce is the equivalent of a financial drive-by shooting, particularly commerce conducted by the not for profit systems. I believed then as I do now that a facility owned and controlled by the physicians who work there was the model most likely to ensure that patients were not financially brutalized. My great-uncle was the only physician in a small Oklahoma town for years, living in the top floor of his house, the bottom floor serving as his clinic and the town’s hospital. He was completely accountable for the entirety of what his patients were charged. He could do everything about what they were charged, including charge them nothing, and this he did regularly. Dr. Walter Bayes was a hero in the town of Chickasha and very well to do. Ownership of the facility or institution by doctors was the rule until government intervention in the 1950s and ’60s made this model more difficult. The explosion of hospital charges in the 1990s, at the same time they claimed they were going broke, created an opportunity for physicians to once again own facilities and demonstrate the superiority of the model. This disintermediated model was superior, as it allowed for the elimination of the greediest profit seeker from the equation: the not-for-profit hospital.

In April of 1997 Dr. Steve Lantier and I walked away from our hospital anesthesia practices and opened the facility thirty days later with ten surgeons with whom we had a good working relationship. We had no idea if we would break even, make money, or go broke trying. We had no pro forma. We had no business experience. All we knew was that hospitals were awful and inefficient places charging patients gigantic prices. The opportunity seemed obvious. Our faith in this dream and in the idea that if you are cheaper and better you will beat the competition formed the basis of our business plan. We also decided that we would never accept a dime of government money, and to this day never have.

The first week we were open, we received a call from a patient who had a breast mass she wanted removed, and she wanted to know how much we would charge her, as she had no insurance. This was the call we had all hoped for, the reason we had opened, and yet I had no idea how to answer her question. I placed her on hold and called our general surgeon and asked him how much he wanted for his fee. He had no idea. I told him to pick a fee or, like a Harvard professor, I’d pick one for him. He said $500. I thought this was very reasonable so I hung up on him before he had a chance to reconsider. As an anesthesiologist, I basically bill for my time and I knew this surgery would take twenty or thirty minutes. The facility supplies were minimal. I was about to take her off hold when I realized she would want to know if she had cancer. I called a pathologist friend and asked him how much he wanted to examine the specimen. He had no idea. I pressed for an answer. Twenty-eight dollars for the pathology. I informed the patient that our price was $1,900. “For what?” she asked. “For everything,” I said. She said, “That’s funny. The hospital down the street from you wanted $19,000 for the facility fee alone.” I knew we were on the right track when after the case and the supply cost was tallied, we’d made a profit. Had the pathology fees that apply to the examination of breast masses not increased, our price would be the same now as it was in 1997, but alas it is now $2,365. Only three other fees have increased since we began quoting them over the phone in 1997.

Word spread and many uninsured patients came to our facility, along with patients with high-deductible health plans and HSAs [health savings accounts]. Most of the Division I athletes had their surgery at our facility, and our reputation in the community grew more solid every day. Dr. Lantier and I were both trained in pediatric anesthesia and particularly enjoyed this part of our practice. Nothing better builds the practice of an anesthesiologist than the careful anesthetic treatment of someone’s child. The area hospitals hated us because patients could buy their surgeries at our facility for less than their insurance deductible at the hospitals. Paradoxically, no insurance companies would work with us. We would not understand any of this until much later, when our posted prices clarified this for us. We were very busy and very successful, early on. Within six months, I was distributing sizeable profits to the partners monthly, while usually charging one-tenth what the hospitals were charging for the same service. We added to our “quote over the phone” price list every week, so patients could have an answer to their price question immediately.

It was no surprise to us that the hospitals were the first to attack us. They attacked us directly by attempting to ban physician ownership of facilities in the state. This was done under the banner of trauma care, the hospitals falsely claiming that if surgeons owned their own facilities, they would not treat trauma patients. No one knew, including me, that when the state legislature created the state trauma task force the underlying mission was to close physician-owned facilities. A Democrat legislator who saw us as an underdog, a champion of the poor, told me with a wink and a nod that I needed to be on this task force, a business-saving favor he and I have since acknowledged. Our facility, and another that had copied our model, were the obvious targets of this task force and surprisingly there was no plan in place if representatives of either of our facilities argued our case in person. Our unexpected invitation and inclusion in this wannabe Star Chamber derailed their plans to ban our existence.

It is worth noting that in our early days Oklahoma Democrat legislators saw us as underdogs. I asked legislators to just leave us alone and to dismiss efforts to hamstring our operation. The Republicans, early champions of their crony hospital pals, now champion our approach, an approach that now receives the bipartisan neglect we desired.

In another direct attack, the big hospitals attempted to pass what became known as the 30 percent law. If passed, a facility had to receive at least 30 percent of its revenue from Medicare, Medicaid, or uncompensated care. Noncompliance was punished by payment of a penalty calculated to equal the degree of failure to comply. Obviously, the state government would be combing through our financial records and assessing a penalty equal to 30 percent of our gross income, since we accepted no government funds. This was aimed squarely at our facility. Once again, a Democrat, Representative Fred Stanley, used his muscle to ensure that this legislation went nowhere. This law was debated in public forums, to some of which I was invited to speak. In one heated exchange, a normally tight-lipped hospital executive asked me how much of our surgery center’s revenue was uncompensated care. I was confused by his question, meant by him to be a devastating rebuttal to my remarks, but, haunted by the insanity of his question, began to wonder if he had misspoken. Was uncompensated care a revenue item? Most people would think that uncompensated care is care delivered for which no compensation is received. Not true, it turns out.

In another attack, the state health department was weaponized by the big hospitals in an attempt to secure the medical records of all patients treated at our facility in the year 2000. After they attempted to invalidate our operating license for failure to comply, we sued them only to discover they lacked the statutory authority to seize these records. Their surrender is framed on the wall of my office.

Because patients could pay the entirety of the cost of their care for less than their deductible and copay at in-network area hospitals, the insurance companies, paying us out of network, received intense pressure from the area hospitals for this lost business. Likely threatened with retaliation in the form of higher prices billed to the insurance companies by these hospitals, the insurance groups began stacking deductibles, a process where patients going out of network had to meet their in-network deductible, then start again at “zero” to accumulate any out-of-network benefit. This deductible stacking put our facility out of financial reach of most patients who were insured who would otherwise rather pay us directly. Our waiting room was empty, and we faced closure. Up until this point we had grown so rapidly that we had built the large facility we now occupy, and fortunately paid for its construction without debt. This brand-new facility was now without patients. The timing of this deductible stacking could not have been worse.

Keep in mind that our reputation was unsurpassed. We were cheaper and we were better than any other venue. In an unfettered market, there should have been a line around the block. Why had the insurance companies been complicit in this savage attack? Wouldn’t they benefit from higher quality and lower prices?

I decided to post our prices online. We had our list of “over the phone prices,” after all. It was a matter of launching a website, ensuring the surgeons were satisfied with their fees, and posting the prices. All of our prices were determined using the following method: I asked the surgeon how much they wanted, then added a price for anesthesia service based primarily on time. The facility portion was priced as time and materials. The rest is addition, not algebra, for those who say this can’t be done. I have increased only three prices since we began quoting them over the phone in 1997 and have lowered many more. I posted these prices in 2009 with three goals in mind: make ourselves more known to those with sticker shock; start a price war; and better understand the scams at work that had emptied our waiting room. We’ve accomplished these goals and more.

The first patients to arrive after we posted prices were Canadians. This was instructive, as these patients had so-called insurance coverage. There was no access, however, to the care that many of them required. The most common story then as now for the Canadians was a patient waiting two years to see a gynecologist for a hysterectomy to stop their bleeding, bleeding usually so severe that intermittent transfusions were required. For $8,000, which covers the facility, surgeon, anesthesia, pathology, and an overnight stay at the surgery center, Canadians can end their nightmare. The first question a Canadian asks when they call us is how long they’ll have to wait. Our answer that there is no waiting time is met with disbelief. A Canadian friend of mine has told me the old joke that no Canadian is truly content unless standing in line. You should know that there are Harriet Tubman–like brokers who help Canadians cross the border, finding for them affordable medical solutions essentially unavailable in Canada. The Canadian system is working proof that bureaucratic rationing is a murderous disaster, whatever flaws market naysayers can conjure up about market allocation of resources. Millions of Canadians have discovered that the only single payer upon which they can truly rely is themselves.

Uninsured Americans responded to the website shortly after the Canadians, many traveling from faraway places like Wisconsin and Alaska. While there are many examples of money saved uninsured individuals, one that sticks out is the patient from Georgia who required a urologic procedure, and who had received a quote of $40,000, just for the facility charge. A friend had told him about our facility and after he confirmed that our all-inclusive price was $4,000, he informed his urologist he was traveling to Oklahoma City. Having lost another patient to us the previous month, the urologist contacted the hospital and told them something had to be done, as their price quotes were causing him to lose patients. The hospital matched our price and the patient stayed in Georgia. The patient later told me that we had saved him $36,000 and we hadn’t even performed his surgery. I like to think about what patients do with the money they didn’t unnecessarily spend on an overpriced surgery. Self-funded companies, about which I’ll have more to say later, discovered our facility, and fast-forwarding to today, about three hundred employers from all fifty states now pay 100 percent of the employee’s bill and travel expense to undergo surgery at our facility.

Business was slow, however, after first launching the website in 2009. Why didn’t everyone want to buy cheaper and better? Why wouldn’t insurance companies want to buy from us? What was this business about uncompensated care? The answers to these questions were revealed following my introduction to Jay Kempton, the first to refer his self-funded clients to us and who later suggested we launch the FMMA [Free Market Medical Association]. If uncompensated care was a revenue item, how was this calculated? It turns out that hospitals need all the red ink they can find to justify the fiction of their not-for-profit status. If a hospital charges $100,000 and only collects $20,000, their books show that they lost $80,000. This fictitious loss performs two functions. First, it helps maintain their not-for-profit fiction, providing the justification needed to eliminate their tax burden. Second, this loss number forms the basis for a kickback the hospitals are paid by Uncle Sam to the extent they claim these losses. To be clear, hospitals receive federal payments based on the charged amounts they claim to not collect. Or as I like to say, hospitals are paid even when they aren’t paid. This is the revenue of uncompensated care, also known as disproportionate share hospital payments. The more they charge and don’t collect, the more they make, basically. This is why there is a crane building on to every emergency room in the country. This also explains how hospitals can claim they are going broke on paper while purchasing television ads during the Super Bowl and buying out their competitors and physician practices.

Why would insurance companies go along with this? Why would an insurance company play along, discounting $100,000 bills to $20,000? Insurance companies sell access to their networks based on the strength of their ability to apply discounts. The larger the discount, the more marketable selling access to the discounting network becomes. The ERISA [Employee Retirement Income Security Act] lawyer Cori Cook frequently poses the following question: “If I tell you I’ll sell you my house for 50 percent off, what should be your next question?” Everywhere but in the medical industry, the answer is obviously “50 percent off what?” “We give bigger discounts” is the phrase commonly used by brokers peddling whatever insurance plan is paying them the highest commissions. There is another reason the insurance companies love the high initial charge from the hospital and play along. “Claims repricing” is the phrase frequently used in the industry to describe this discounting of hospital charges. Think of insurance companies as claims repricers who charge for this service. It is standard for an insurance company to charge an employer health plan a percentage of the discount they achieve on a hospital bill. It is not hard to see that the higher the initial hospital charge, the more the insurance company makes repricing the claims. Unknown to most employers is the fact that hospital pricing and discounts are prenegotiated, so no discount actually exists. I’ve been told it is not uncommon for an insurance company representative to ask a hospital to charge more for a service so the repricing commission paid to the insurance company is maximized. Claims repricing represents an opportunity foregone when prices are posted for all to see, another reason the insurance companies want nothing to do with my facility.

While big hospitals and insurance companies and Big Pharma and many others deserve all the thumping they get, it is important to acknowledge that none of their theft is possible without the favors auctioned to them in Washington, and that Uncle Sam always drives the getaway car. High prices and sporadic quality have been the result not of the failure of the free market, but of the absence of the free market. To quote Hans Hoppe, “markets deliver goods and governments deliver bads.Nowhere is this more evident than in the medical industry. Everything people in this country hate about the medical industry is the “bads” that government has delivered. Some “bads” are those which under the banner of patient safety or consumer protection regulate the smaller innovators out of business, usually in the form of requirements or conditions which only the most gigantic cronies can endure. The medical loss ratio, part of the un-Affordable Care Act, is an example. While a requirement that no more than 30 percent of an insurance company’s revenue can be spent on administrative duties is a requirement with which the giant insurance companies could comply, the smaller companies were annihilated. It is no mistake that there are now just four or five medical insurance carriers.

There are many more examples of federal “bads.” The un-Affordable Care Act gained the endorsement of the American Hospital Association only after they secured a ban on the construction or expansion of physician-owned hospitals. Here are more “bads” you may not know. Medicare pays hospitals multiples of what they pay for the very same service rendered in a surgery center. Medicare pays more for physician services when the physician is employed by a hospital. This discrimination against physicians in private practice has driven many physicians into the arms of hospitals happy to gobble up their practices. In addition, the AMA [American Medical Association], to which I do not belong, is paid by Uncle Sam to inflict the most indecipherable payment codes on physicians, and doctors unsupported by a large staff of decoders are placed at an obvious disadvantage. You can now see why hospitals and insurance companies are resistant to price transparency. Uncle Sam has played along to maintain the number of crony favors in their inventory.

You know now why I laugh when I’m asked, “Why isn’t this free market movement in your industry more widespread?” It’s astonishing that it exists at all. Its growth is even more remarkable. If you have no insurance, think of yourself as self-funded. You should know that entire companies self-fund for the medical needs of their employees, paying their bills out of operational revenue. They serve as proxy buyers for their employees, as my friend Marty Makary has said. They are responsible for 80 percent of medical bills not paid by government and are therefore large enough in size to make demands that even the dysfunctional cartel can’t ignore. The free market movement’s growth can be attributed largely to the increasing number of these self-funded buyers expecting market discipline from organizations like mine. Cost-sharing ministries are another large buyer, also expecting market-based services. Direct conversations between these buyers and sellers has opened the eyes of many doctors to more sound economic thinking. One of the goals of the Free Market Medical Association has been to promote sound economic thinking, as we believe that flawed thinking, many times by well-intentioned individuals, has led the industry down failed paths. I believe the Surgery Center of Oklahoma is open only because of our economic grounding. Our dedication to the principle of property rights has kept government money out of our facility. We have no contracts with the insurance cronies and display our all-inclusive pricing. For the exchange to be mutually beneficial, for us to earn an honest buck, we’ve had to deliver a service that consumers with a choice value. The idea that value determination is completely consumer and patient generated has been very helpful to our organization. It has, for instance, cleansed our partnership of the notion prevalent in medicine that one should be paid according to their effort, a clear outgrowth of the flawed labor theory of value. Our partnership agreement is an application of time preference, preventing aging partners from embracing the short-sightedness destructive to the firm. Our dedication to a pure free market model, a journey that is still underway, has been our mission and goal, as we knew that maximum consumer and patient benefit would be the result. Other members of the Free Market Medical Association have gained insights critical to the success of their practices by matching their strategies with sound economic principles, for which we have the Mises Institute to thank.

Uninsured patients have found visible pricing. A price war has begun. UCLA copied my website word for word, and not, I think because they embrace free market ideas. The cronies and their government pals are increasingly exposed. As the cofounder of the Free Market Medical Association, I am filled with optimism watching the growth and acceptance of market discipline in the industry. Our theme at the Free Market Medical Association this year is “are you ready for the red pill?,” a message designed to awaken those comatose self-funded buyers who continue to unnecessarily do business with the cartel. As growth in the number of these sticker-shocked buyers continues, entrepreneurs, aware that the industry is finally prepared to reward the more efficient, will work even harder to satisfy demand in this new and honest fashion. The transformation to a more market-based environment has begun and is flourishing, in spite of decades of efforts by the state to prevent this from happening.

Thank you.

A long read, but worth it.  The medical free market in action, and it works.

 

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10 hours ago, DanteEstonia said:

I'd love to see them tackle COVID. /s

What does a surgery center have to do with treating COVID?  I don't recall the treatment of COVID-19 requiring surgery.

Nice try, Dante.

 

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30 minutes ago, DanteEstonia said:

https://jamanetwork.com/journals/jama/fullarticle/2781358

 

Lots of pre-existing conditions now. 

I'm sure if a lung transplant were warranted due to a severe case of COVID (as the article states "The Option of Last Resort")  this free market surgery center could do it cheaper than a for-profit or non-profit hospital, if it had the doctors and staff for such a complicated procedure.

Tell me Dante, why do insurance companies and government regulations have to insert themselves between myself and a physician for a simple yearly check-up?

 

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On 6/24/2021 at 8:09 AM, Muda69 said:

I'm sure if a lung transplant were warranted due to a severe case of COVID (as the article states "The Option of Last Resort")  this free market surgery center could do it cheaper than a for-profit or non-profit hospital, if it had the doctors and staff for such a complicated procedure.

Tell me Dante, why do insurance companies and government regulations have to insert themselves between myself and a physician for a simple yearly check-up?

 

Tell me why no functioning country uses a “free market” health system instead, if it’s such a good idea.

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6 minutes ago, DanteEstonia said:

Tell me why no functioning country uses a “free market” health system instead, if it’s such a good idea.

Answer my question first Dante, and I will then attempt to answer yours.  But if you believe Canada has a "functioning" nationalized health care system then you and I have very different definitions of that word.

 

 

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1 minute ago, Muda69 said:

Answer my question first Dante, and I will then attempt to answer yours.  But if you believe Canada has a "functioning" nationalized health care system then you and I have very different definitions of that word.

 

 

I never said a words about Canada.

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2 minutes ago, DanteEstonia said:

I never said a words about Canada.

Yeah, you really did:

Quote

Tell me why no functioning country uses a “free market” health system instead, if it’s such a good idea.

 

  • Kill me now 1
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On 6/26/2021 at 5:55 PM, DanteEstonia said:

Don't see anything in there about Canada. 

So you believe Canada is a non-functioning country?

10 hours ago, DanteEstonia said:

Here's some frEe markeT HeaLTHCare -

 

Sorry that you hate choice and freedom, Dante.

 

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2 hours ago, DanteEstonia said:

Sorry that you love "religious organizations" that fleece people. 

Were these people forced into those agreements?

Sorry that you hate Caveat Emptor, and believe the government should protect you from virtually all your stupid mistakes.

 

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4 hours ago, Muda69 said:

Sorry that you hate Caveat Emptor, and believe the government should protect you from virtually all your stupid mistakes.

I'm sorry that you believe in permitting deceit and fraud, as in the case with these "ministries". 

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13 hours ago, DanteEstonia said:

I'm sorry that you believe in permitting deceit and fraud, as in the case with these "ministries". 

Again, Caveat Emptor.  And if an individual believes they were defrauded by one of these organizations there are legal remedies available.   Such remedies are a legitimate function of government, while running/administrating an entire medical service edifice is not.

 

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2 hours ago, DanteEstonia said:

Again, theft and fraud. 

Fool me once shame in you. Fool me twice shame on me.  

Sounds like you have been fooled multiple times in your young life Dante, always expecting nanny government to to protect you from making bad decisions.

2 hours ago, DanteEstonia said:

 

At least not, in your view.

In the view of any individual who truly values personal freedom and responsibility.

And you still haven't answered my question from June 24th.  Quite telling..................

 

 

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  • 2 weeks later...
On 7/10/2021 at 11:29 AM, DanteEstonia said:

Please paste a link to that question, and I'll answer it. 

I'll just requote it for you:

 

"Tell me Dante, why do insurance companies and government regulations have to insert themselves between myself and a physician for a simple yearly check-up?"

 

 

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