By Patrick B. McGuigan
OKLAHOMA CITY – Opposition to the Affordable Care Act is only one of the reasons Dr. G. Keith Smith is scheduled to appear Monday night on Bill O’Reilly’s Fox News program.
Smith and his colleagues have since the early 1990s rebuffed not only federal health care funding, but most “Big Insurance” requirements as well. The center is thriving as a model for affordable, market-oriented, cash-basis health care. Further, the facility’s physicians and staff share a commitment to provide reduced-cost or pro bono care for the less fortunate.
The Surgery Center has garnered rave reviews and sympathetic news stories in the regional and national news media, including in Oklahoma’s largest newspaper. He now regularly briefs members of Congress (http://www.prnewswire.com/news-releases/physicians-to-tell-capitol-hill-our-patients-need-options-not-mandates-162609456.html).
The notoriety came slow, at first. It built the past two years, after stories that gained wide circulation through Reason.com (http://reason.com/reasontv/2012/11/15/the-obamacare-revolt-oklahoma-doctors-fi), Watchdog.org (http://watchdog.org/65686/mcguigan-markets-mandates-and-the-right-doctors/), CapitolBeatOK.com, at blogs for the Oklahoma Council of Public Affairs, and on the John Stoessel program (http://www.youtube.com/watch?v=hb_woGzJXTY).
Dr. Smith has become a “go-to” guy for analysts, regardless of philosophy, who want a thoughtful market-oriented critique of the current and emerging state of American health care delivery.
His distrust of government came early, less a form of rebellion against his father — whom he describes as (at least in those years) “an open-minded socialist, and a smart one” – and more like a “philosophical journey together, him from the left, me…well…apolitical.”
Convinced things in Russia could not be as bad as claimed, the elder Smith went to the former Soviet Union to see for himself.
The result: “He did a 180 degree turnaround. I was proud at the time because I saw how honest my father was, how he close to be more in the real world. His trip to Russia made him think and talk to our family about freedom and how important it was, and how special America is.”
Still in those formative years, Smith and his father read Frederic Bastiat’s classic treatise, “The Law.” Then, the young Smith delved into the writings of Lew Rockwell and the libertarian philosophy of the Mises Institute.
What locked Dr. Smith into a liberty perspective for medical care not only his personal experiences, but also the practical influence of his mentor, Dr. Jim Porter of Arkansas.
Porter was, Smith contends, more than smart enough to do any kind of work he wished: “Physicians in academic centers often times look down their noses at the folks out in private practice as ‘adequate’ but ‘greedy.’ Because academicians are salaried and aren’t paid for each patient they see, they ‘aren’t in it for the money like those greedy private practice guys.’
“Somehow brilliance can only be found in an academic center, if you were to ask many of them. I will not embarrass the infectious disease doctor, or the pulmonologist, or the anesthesiologists or the surgeons or the emergency room doctor or the radiologist that I have known in private practice whose brilliance and dedication can only be described as….well…talent to burn. I will name Dr. Jim Porter.” (http://032a410.netsolhost.com/WordPress/?p=671)
A decade and a half into his rejection of federal dollars and insurance limitations, in 2009, Dr. Smith began to post prices for 112 common surgical procedures at his facility, established with his partner, Dr. Steve Lantier, in 1997 (http://watchdog.org/64814/ok-surgery-centers-cash-only-approach-offers-transparency-efficiency-affordability/). The center avoids entanglement in Medicare and Medicaid, and only carefully engages with private health insurance – providing information to patients who can submit to their insurers if they wish to do so.
This health-care business was based on confidence they could provide top-tier procedures at a fraction of the cost traditional hospitals charge. The successful venture took off after the online price posting was implemented.
The center’s approach yields patient bills that can be laid out with all costs on a single page. Cost of the center’s procedures is sometimes one-tenth, and often around one-sixth, of the price at a traditional hospital.
Smith and his staff do not haggle with insurers. They stick to their stated and listed price – except to lower it in special circumstances.
Smith’s approach, making common surgical procedures affordable for working people and many uninsured, has garnered honors from the Oklahoma Department of Labor, run by a conservative Republican, and from the black Democratic politicians who represent the area that includes the center (http://watchdog.org/67567/ok-republican-commissioner-legislative-democrats-tout-free-market-surgery-center/)
In a recent notable case, an Oklahoma family with several adopted children from Africa latched on to a “BOGO” (buy one, get one) offer from the center, to pay for hernia surgeries for two youngsters (http://www.capitolbeatok.com/reports/bogo-from-africa-to-anadarko-a-story-of-love-and-markets).
Smith reports the vast majority of patients at the center are drawn initially by lower prices, but retained by high-quality care. In slow motion, online transparency for medical costs is catching on in Oklahoma.
When he turns up on O’Reilly’s show and other national venues, many of the questions Smith fields focus on the Affordable Care Act, to which he is adamantly and articulately opposed. But informed critiques of “ObamaCare” are just part — and perhaps not even the most important part — of the story Dr. G. Keith Smith has to tell.