“Repeal and replace?” No thanks


By G. Keith Smith, M.D.



Republicans are being urged to “repeal and replace” Obamacare (the so-called Affordable Care Act). No thanks. If you think O’Connellcare will be better than Obamacare, I would ask you to think again. If we are unlucky enough to experience the Republican version of Obamacare, I predict we’ll soon be longing for these last dying days of Obamacare, a time during which hope for a break from D.C. central health planning seemed realistic.

If you reside on the left end of the political spectrum, you would be wrong to think I am a fan of the Unaffordable (Unavailable) Care Act. If you are on the right end, you would be correct to think I believe the Republicans are no better than Democrats at planning people’s lives for them. Central planning, donning whatever stripes, never works as advertised.

How about “repeal and repeal”? And keep on repealing. Expecting great things from O’Connellcare is akin to expecting a different outcome when offering gin rather than vodka to an alcoholic. Perhaps it is time to just admit that we all have a problem, always being naively drawn to the next political messiah who promises a new program to deliver us from the disaster created by the last government program.

Now before you dismiss me for condemning a Republican replacement for Obamacare even before it is written, consider that every major intervention by the federal government in the economy has resulted in wild and unbelievable taxpayer-funded profits for the corporate crony insiders.

While many cheer the regulators that are going to bring the evil corporations to their knees, I would argue that these regulations (that only the industry giants can afford) are designed and implemented to crush the underdogs and upstarts and are invariably written by the beneficiaries of this game. This leads to the predictable industry consolidation that ratchets up the cronies’ market share. When will we finally acknowledge the revolving career door, through which head regulators of countless federal agencies walk to rule the corporate giants they had been regulating just the day before?

I don’t need to see O’Connellcare to know that it is more of the same and will be designed with the same results and goals in mind. Facing the possibility of losing their new and direct access to taxpayer loot, the cronies will predictably pay (and Republican legislators will happily accept) a ransom to maintain the current scam during the coming O’Connellcare shakedown.

Think I am too cynical? How many insurance companies were there prior to Obamacare? How many are there now? How do the stock prices of those remaining compare to the time prior to Obamacare’s passage? After all, how would you like to sell a product or service, the purchase of which was mandatory? Think you would make money? Let’s not limit our focus to the insurance companies. Look at the shrinking number of publicly traded hospital stocks or gains of the health information technology company stocks. Think the Republican replacement will attack these strongholds?

How about replacing Obamacare with freedom? The good news is that 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.

Skeptics may claim that the free market has failed in medicine. Other than the alternatives mentioned above (and Lasik and plastic surgery), the free market has been absent in the medical marketplace, thwarted at every turn and opportunity by those who have profited from the cartel-like arrangement that so accurately characterizes the government enabled U.S. “healthcare delivery system.”

Healthcare cronyism has few industry equivalents, and the predictable disruption of the entire medical market for the benefit of a few has been a deadly and bankrupting experience for many individuals. Individual health and freedom will always remain far too important to trust to the countless intrigues of the federal government and its latest program.

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Author / Contributor bio: Dr. G. Keith Smith 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.

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.

Dr. Smith resides in Oklahoma City, Oklahoma.

By G. Keith Smith, M.D.

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