Dr. Jeffrey Singer wrote this piece for Reason Magazine this week.  His article explains why the number of Canadians fleeing to the United States for surgery may have peaked and might indeed be falling.  As the Canadian system continues its death spiral, private health clinics and mini-hospitals operating on a cash basis are springing up all over the country, this new trend due to the heroic efforts of one physician, Dr. Jacques Chaouilli, profiled in Dr. Singer’s article.

Dr. Singer also clubs the U.S. system on the head and mentions the wave of private clinics and hospitals (The Surgery Center of Oklahoma amongst them) that are rising to meet demand and provide affordable and rationally priced care.  He very appropriately lays the blame for the mess in the U.S. at the feet of the federal government and their corporate health cronies.  Even the disastrous practice of hospitals employing physicians receives this article’s barbs.

It is very unusual for me to encounter an article like this where I agree with every single point the author makes.  I do agree with Dr. Singer on all but one point and I would look forward to discussing this with him at some point…and here it is.  

If the movement toward rational and transparent healthcare pricing continues, the resulting price war will bring prices down to a level where even those of modest means will be able to afford care, without government and even without insurance (catastrophic insurance will still have a place, I think).


Call me an optimist, but in the pricing trenches, I like what I am seeing so far.  If the “state” intervenes, however, the dismal future of medicine Dr. Singer predicts where only the wealthy and connected will have access is likely, however.  Let’s hope my optimism isn’t proven naive.

G. Keith Smith, M.D.