I had the pleasure of spending some time today with a clear thinker and communicator.  This individual (someone I had heard of but had never met) had expressed an interest in our business model and asked for an hour to learn more.  After listening for 45 minutes (without saying much of anything, only asking questions) one of his/her assistants appeared.  For the next five minutes, I was witness to something quite remarkable. The essence of the previous  45 minutes was presented by this individual to the assistant without any gaps, nothing omitted.  

Clear and concise minds like this never cease to amaze me.  My good friend and lawyer who masterminded our partnership structure at the surgery center has a mind like this.  Extremely complex agreements and contracts frequently encompass an entire two pages when penned by him.  The great political writer, Joe Sobran wrote like this, writing single sentences that spoke more than entire pages someone else would write.

I confess that while I try to be concise and clear in my writing, I am constantly guarding against being otherwise.  If and when I am not clear or concise, it is a result of my grappling with my abilities as a writer.  Not educated or trained to write, efficiency of word use and clear expression does not come naturally to me.  When I read some of my early blogs, however, I can see that I have improved, although I hope to continue to improve.

I am writing this because I recently viewed an individual talking about healthcare on a national network, who was intentionally unclear and imprecise.  This has to be because he has something to hide or rather that he believes that his vague and opaque remarks somehow make him look more intelligent, since no one could possibly understand what he said or meant.  It made me think of my dad’s favorite saying:  ”eschew obfuscation.”

Health care in this country is a mess.  Making us all believe that it is an incomprehensible and complex mess, the mission of the architects of health propaganda, has made these same folks and many of their cronies quite wealthy.  Whenever you hear one of the countless talking heads talking about the business or the delivery of health care in hard to understand terms or language, your skeptic radar should go on red alert.  The truth is that people like this don’t want you to understand.  They don’t want you to know the truth.  They don’t want you to think about PPO repricing or the uncompensated care scam or the countless kickbacks or the duplicitous book keeping practices that are commonplace in the industry.  They don’t want you to know because as long as you don’t know, you won’t know how to ask how they are scamming all of us.  

The economics and delivery of health care are no different than the economics and deliver of any other products and services.  Industries that are heavily subsidized and regulated benefit those behind the subsidies and regulations, health care included.  Part of the reason we put our prices online 4 years ago was to show that it could be done.  We have done it and are profitable at prices less than what Medicaid pays the local hospitals for the same procedures.  We are profitable at less than half what Medicare pays the big hospitals for the same procedures.

Watch out for those who speak of medical price transparency as an impossibility.  Soon after beginning their remarks, the terms they use will become unfamiliar and they will speak in abbreviations and increasingly use acronyms.  They will speak of “this complex industry” with increasingly complex speech.  Most of the time this is intentional, devious and deceptive, meant to protect the cronies and folks behind the curtain who wish to remain undiscovered, lest their scams be known.

G. Keith Smith, M.D.