**EconTalk: Keith Smith on Free Market Health Care **
(1) Describe what happens, with whom, why is it entrepreneurship/entrepreneurial?
This podcast is a conversation with Keith Smith, anesthesiologist and co-founder of Surgery Center of Oklahoma, and Russ Roberts host of the EconTalk podcast. Keith tells the story of how the Surgery Center of Oklahoma began. He explained that at the beginning when he was starting this clinic, he asked a colleague how much he would normally charge for a surgery. Shockingly, he had no idea, he said that all of the pricing and charging processes were managed by the hospital he worked at. Keith told his colleague to forget about the hospital prices and told him to set a price that he would charge himself. This price was a third of what a hospital would charge, and following this process is how the Surgery Center of Oklahoma was created.
Also, Keith mentioned that a big particularity of this clinic, besides the incredible low prices for medical procedures, is that they don’t accept any kind of insurance. Everything must be paid with cash or check, and now they are starting to accept credit cards. Also, all of the medical procedures are addressed in a personalized way. This means that, if a person comes to the Surgery Center of Oklahoma and requires a medical procedure and has no money, the doctors in the clinic will perform the procedure required to the patient and make their health a priority, even if the patient has no money to pay for the services. Part of the conversation was about how our current health system is so broken and corrupted because of the big participation of the government in the health system and how a free market would look like in the near future.
(2) Why it is interesting?
I found this episode of the podcast very interesting, because one thing that I have been struggling since I moved to the US is understanding the health system. After listening to Keith conversation about the US health system, I can understand better how hospitals operate, why many people are very concern when needing a medical intervention, and how money is a key factor in the health system in the US. It is also interesting how the Surgery Center of Oklahoma adopted the concept of accepting no insurance as payment, when most, if not every hospital, operate through insurance companies and prices for everything.
(3) How does this aspect of entrepreneurship affect society? How does society affect/stifle/support this aspect of entrepreneurship? What is the interaction between this aspect of entrepreneurship and society like?
Keith is a big motive of inspiration for many entrepreneurs. He is fighting an impenetrable system that is the health system in the US. I was shocked to hear how hospitals and insurance companies operate hand in hand to come up with high prices to create more profit. Also, a stunning fact that I also learned from this conversation is that hospitals, even though they are considered private institutions, they receive great funding from the federal government. Also, because many of them are considered ‘non-profit’ organizations, hospitals are exempt from taxes, which is a fact that I did not know about.
From my perspective, I can see how this health system escalated to the way it is today, however, I believe it is pretty much profit-focused and no people-health-focused. What Keith is trying to fix with the Surgery Center of Oklahoma is the main focus and goals of medical institutions, proof of that are the payment methods that the Surgery center accepts. The way that the Surgery Center of Oklahoma is serving customers is by getting to know them, as Keith explained in the podcast, by knowing the patient’s information they would know how they were going to charge them. On the other hand, when patients go to big hospitals often times it feels like they are treated like another number for their business.
I fully admire what Keith is trying to do, providing affordable and personalized health services for people. I would have thought that with the big power that hospitals have in the market and the government, a clinic like the Surgery Center of Oklahoma would go bankrupt rapidly. However, reality has proven that this is not true, and that people are having a positive reaction to it, hopefully this translates into a change in the health system in the US in a near future.