Not long ago we operated on both knees of an uninsured man at the same time.  He had been quoted $20,000 by a local hospital for the facility fee.  Well, not exactly.  They actually told him that he would need to put $20,000 down as a deposit with the balance of the charges due at the conclusion of his surgery, depending on what supplies were needed.  This did not include the charges from the anesthesiologist or the surgeon.  He was ready to travel to Thailand or Costa Rica to have his surgery as the local charges were cost prohibitive for him.  He found our surgery center through an online broker who helps people find affordable care.  We happen to be his favorite facility for outpatient surgery due to price and patient satisfaction.  We did his surgery for $5600.  That was for everything and everyone.  I started thinking about the amount of money that we have saved people over the years because stories like this are common place, not the exception.  We have been doing this since 1997 so I hesitate to even guess about the “money saved” number.  What is just as important is that without our facility and our pricing, many of these patients would never have had surgery at all. I am also reminded of an economic concept that the great Frederic Bastiat coined call “The Broken Window Fallacy.”  He was demonstrating the idea of “what is seen” and “what is not seen.”  Some people see a broken window as a good thing for local businessmen involved in the repairs.  But the more accurate assessment is that this local business stimulation just returns the situation to the pre-broken window state, i.e., there is no improvement on the prior condition.  Bastiat stresses that we must account for “what is not seen,” i.e, what would that repair money have done had it not been used to get us right back where we were…how might our condition have been improved?  Was it a pair of shoes that we might have purchased instead of repairing the window?  Was it some new tool for our business that makes us more productive and might actually lead to job creation?

Part of “what is not seen” is what patients without insurance that have had affordable surgical procedures at our facility have done with the money that they saved.  Did they buy new clothes for their children?  Did they replace a broken down vehicle with a newer, maybe safer model?  Did the family go on a vacation?  Were they able to buy healthier groceries?  Who knows?  This is “what is not seen” but that does not mean that it is not important.  Could it be that the more patients operated on at our facility, the better for the local economy due to the savings to individuals and the increase in their disposable income?

We are thrilled to be part of the solution, not part of the problem.  Once again, we welcome others who care to join us in providing global and transparent pricing.

G. Keith Smith, M.D.