So glad to see discussions talking about having a market based healthcare. Despite what people think, healthcare was broken by the government and hasn't been a free market for several decades.
Yes it seems most people decry healthcare as the problem but it’s really the broken way we PAY FOR healthcare that’s causing so much financial distress. If healthcare in the U.S. was transacted like any other good and service exchange between buyers and sellers, then competition would be allowed to help drive costs down and innovation up. Until that happens, we are slowly walking the plank…
We certainly will. It’s personally rewarding to get a couple hours with someone like Dr Keith Smith, so to be able to share insights from people like him is a real treat.
Dr. Smith and Cynthia fisher must be BFFs. Free market idealation in healthcare is great until you realize the basis of "fairly priced services" is a mechanism that inherently prices out enough patients until an equilibrium price is met.
If those fairly priced services are well below the commercial insurance allowable amount, then how does that price patients out? I would love to understand your vantage point better. Thank you for commenting!
@@SelfFunded Basically two points here - one pushes back against extreme libertarianism. While the price transparency goal is fantastic and much-needed, believe it or not, there are many many people in this country who can't afford even a $2000 procedure, and that's where government programs like Medicaid come in, which Dr. Smith seems to imply is part of the government "cesspool". And I don't disagree Medicaid is expensive, flawed, and exploitable, but let's not claim a pure free market is in the best interests of people who are to the left of the equilibrium price point. Second point is trickier to talk about without sounding like I'm defending commercial insurance, which I'm really not. The point here is basically adverse selection. Insurance spreads out risks, and thus costs (how efficiently and fairly it achieves this is the thorny part). Some, maybe even most, procedures and treatments are relatively low cost, but some are indeed high cost. These high cost chemotherapies, sepsis cases, etc. would be exorbitant if priced at even a "fair" cost+1% margin. The point of insurance is to make these events more affordable for patients and by doing so, either raise premiums or raise costs of cheaper services as well (agreed that insurance as-is fails to do this in a consumer-minded manner). So yes, Dr. Smith and other ASCs indeed spot and exploit market inefficiencies here, by specializing in relatively low-cost procedures and surgeries, and letting places like local public safety net hospitals take on the rest. And to be fair, what Dr. Smith is doing is a great counter-balance to predatory insurer practices, and we could use more of that right now. But scaling this 100% on a nation-wide economic scale isn't good either - you're picking off low-cost patients and ignoring high-cost patients, worsening adverse selection. Anyway, discovered your channel last week, love it, and always find it great food for thought. Thanks!
