TRANSCRIPT: Hello. Dr. Keith Smith with you – Surgery Center of Oklahoma. Thank you for joining us in this video blog series.

We receive a lot of criticism from hospital apologists on social media. And 2 of the most common are that we are not open 24/7, and the other is that we don’t have an emergency room. So we’re really in no position as an outpatient surgery center to criticize hospitals that charge 10 times what we do and claim to not make a profit.

I claim otherwise and I’ll tell you why. I’ve joked with the staff here at the Surgery Center that one of these days, we may be open 24/7, 365 days a year if the hospitals with their high, unreasonable, gouging pricing continue to run patients our direction. Indeed, it is patients who actually pay their bills who come to the Surgery Center of Oklahoma because they have the sticker shock. (Self-funded companies as well.) We’re getting busier and busier and I like to joke about that from time to time.

The other criticism that we don’t have an emergency room is worth commenting on. Emergency rooms are ostensibly the lost leaders in these hospitals – these so-called not-for-profit hospitals – yet there is a crane, it seems, in front of every one I’ve ever seen always building on. I don’t know a business that builds onto their lost leader.

There is hospital chain here in Oklahoma City that’s actually building free-standing emergency rooms. That certainly doesn’t make sense that they’re trying to not lose money in these emergency rooms that are supposedly losing them all this money.

Keep in mind that while there is a high capital expense to start or build a hospital, that after the emergency room is staffed, the increase in marginal costs to add an additional patient approaches zero. It is actually equal to the cost of supplies.

So once an emergency room is open and the staff there is paid hourly, the additional cost of adding a patient, whether they pay them or not, that additional cost is very, very low once that capital expenditure is behind them.

I like to point that out because I do not believe that emergency rooms are losing a lot of money. I think if you factor in all of the tests and X-rays and CAT scans and MRIs in the surgeries are done as a result of the portal of the emergency room, these are actually vital to the success of these so-called not-for-profit hospitals.

I bring this up because the claim that these hospitals are bankrupting us with all the uninsured… that was one of the really big pushes behind ObamaCare. ‘The hospitals are losing money in their emergency rooms so they have to overcharge the rest of us,’ ‘we all have to have coverage’… that’s a big lie and I think it’s worth commenting on and pointing out.

Thank you for joining us. We will see you next time.