1). It is expensive to provide health care.

It actually is not that expensive.  What most hospitals charge for healthcare is another matter altogether.  Even the supply costs are not that expensive and as a health care facility owner/manager I can speak from experience.  Understand that medical facilities are not economically unlike utility companies that incur high fixed costs at startup, but once they are up and running, the additional cost of adding another consumer/patient approaches “zero.”  In other words, hospital overhead doesn’t significantly increase with the addition of more patients.

2). Big city hospital emergency rooms are a big money loser.  

See #1.  Also, if this were true why is there a crane in front of almost everyone of them, building on?  This hospital department represents the portal to some of the most lucrative activities a hospital encompasses with imaging, laboratory and surgery.  One hospital system in Oklahoma is building free standing emergency rooms!  Enough said.

3). Cost shifting is necessary for hospitals to stay afloat.

I’d say they have overdone this a bit, as plenty of money is available for the sponsorship of sports franchises, hostile takeovers of physician practices (particularly those in rural communities), subsequent hostile takeovers of rural hospitals, building and advertising campaigns….I could go on.  Also keep in mind that when hospitals admit to shifting costs to those who pay from those who don’t, they are admitting that they provide no indigent care, after all.  All they are doing is fronting the money to one they are going to take from another, while complaining that they have “lost” money.

4). Not for profit means not make a profit.

It actually means, “don’t pay tax.”  How would you like this deal?  Charging giant sums and “writing down the balances” allows these entities to maintain the fiction of their “not for profit” status.  As I’ve said before, “the one thing these not for profit hospitals are good at is making money.”  Over sixty percent of personal bankruptcies are due to the medical bills that these “charitable” hospitals create.  

5). Physicians referring their patients to the facilities they own represents a conflict of interest, while doctors employed by a hospital referring to their mother ship does not.

Doctors who over-utilize, doctors who do unnecessary surgery are out there.  They typically work for corporate hospitals, though, as fellow physicians don’t want to be co-owners with these idiots due to the increased liability involved.  Seriously, why is it not ok for physicians to own hospitals but it is ok for hospitals to own physicians?  Hospitals lean on their employed doctors to order more MRI’s and lab and do more surgeries all the time, so that they will “earn their keep.”  Exaggerating the complexity of daily hospital visits by hospital-employed physicians, using “cut and paste” electronic medical record technology, is also widely encouraged.   

6). Upfront and transparent pricing is impossible in health care.

We have done it.  Enough said.  Hospitals can’t do this.  Hospitals are doing this.  Ok.  I said more than I should have.

7). Free market principles don’t apply to health care.

Free market principles always apply, in spite of all attempts by the state to thwart them.  Acting in concert and consistent with free market principles allows for the most rational and fair and least wasteful and most moral allocation of resources.  Acting in concert with the free market and its characteristic open competition causes quality to soar and prices to plummet.  Every time, no exceptions.  Patients from all over the country are using our online pricing to leverage better deals in their local medical markets, as our facility and others embracing transparent pricing are only a short plane ride away!  As hard as many hospitals are trying to avoid it, they are in a competitive marketplace whether they like it or not.  Those in the medical industrial complex who say that free market principles don’t apply to their industry are typically those who benefit from avoiding competition at all costs.

8). Patients have no idea how to shop for quality health care.

I have found just the opposite.  Most patients are adept at spotting a charlatan doctor or a poor quality facility.  The first thing many notice is the “treated like a number” feeling.  Patients tend to trust the doctors that will take time to talk with them and explain their condition and options, not force feed them some canned speech.  Contrast this with patients going to see corporate hospital employee doctors, having no idea that these doctors are sending them to specialists and surgeons they are told to patronize, not specialists who are any good.  I think that patients are better off shopping for quality themselves, rather than leaving this to the “network” of employed doctors.  These doctor-employees are too conflicted and compromised.

9). The more you pay for healthcare the better it must be.

Actually the less you pay for health care the more likely it will be of higher quality!  This is counterintuitive but let me explain.  A new participant in the medical marketplace must compete in order to draw patients.  Price is one way to compete.  High quality is another.  Medical entrepreneurs risking their own capital are like any others in that they compete on price and quality to mitigate the risk of losing their shirt.  On the flip side, corporate medicine (most hospitals) has taken steps over the years to insulate their facilities from competitors (licensing requirements, certificates of need, etc.) and feeling less need to compete, don’t risk nearly as much by ignoring quality in their institutions.  When someone recently said to a large hospital CEO,” ..shouldn’t it bother you that your hospital is the worst value, highest priced player in the market,” the CEO said,  ”No.  We have leverage.”

10). Obamacare was promoted by people who care about our health care.

The stock prices of corporate health care soared after Justice Robert’s ruling.  These are the true beneficiaries and the reason this legislation was pushed.  Rather than serve customers and profit from this market action, these corporate hospital players will extract their loot from the taxpayers, the quality of their product or service divorced from any quality or value perception by the patient.  Poor patient care in hospitals will now be treated the same as poor outcomes in public schools.  More money will be thrown at them.  This model of rewarding incompetence will insure that the health care bureaucrats, those who promoted this “law,” will thrive.

– G. Keith Smith, M.D.