2aguy
Diamond Member
- Jul 19, 2014
- 111,967
- 52,236
- 2,290
The story of a free market surgical center....the world needs more of these....
Word spread and many uninsured patients came to our facility, along with patients with high-deductible health plans and HSAs [health savings accounts]. Most of the Division I athletes had their surgery at our facility, and our reputation in the community grew more solid every day. Dr. Lantier and I were both trained in pediatric anesthesia and particularly enjoyed this part of our practice. Nothing better builds the practice of an anesthesiologist than the careful anesthetic treatment of someone’s child.
The area hospitals hated us because patients could buy their surgeries at our facility for less than their insurance deductible at the hospitals.
Paradoxically, no insurance companies would work with us.
We would not understand any of this until much later, when our posted prices clarified this for us. We were very busy and very successful, early on. Within six months, I was distributing sizeable profits to the partners monthly, while usually charging one-tenth what the hospitals were charging for the same service. We added to our “quote over the phone” price list every week, so patients could have an answer to their price question immediately.
----
It was no surprise to us that the hospitals were the first to attack us. They attacked us directly by attempting to ban physician ownership of facilities in the state. This was done under the banner of trauma care, the hospitals falsely claiming that if surgeons owned their own facilities, they would not treat trauma patients. No one knew, including me, that when the state legislature created the state trauma task force the underlying mission was to close physician-owned facilities. A Democrat legislator who saw us as an underdog, a champion of the poor, told me with a wink and a nod that I needed to be on this task force, a business-saving favor he and I have since acknowledged. Our facility, and another that had copied our model, were the obvious targets of this task force and surprisingly there was no plan in place if representatives of either of our facilities argued our case in person. Our unexpected invitation and inclusion in this wannabe Star Chamber derailed their plans to ban our existence.
----
Because patients could pay the entirety of the cost of their care for less than their deductible and copay at in-network area hospitals, the insurance companies, paying us out of network, received intense pressure from the area hospitals for this lost business. Likely threatened with retaliation in the form of higher prices billed to the insurance companies by these hospitals, the insurance groups began stacking deductibles, a process where patients going out of network had to meet their in-network deductible, then start again at “zero” to accumulate any out-of-network benefit. This deductible stacking put our facility out of financial reach of most patients who were insured who would otherwise rather pay us directly. Our waiting room was empty, and we faced closure. Up until this point we had grown so rapidly that we had built the large facility we now occupy, and fortunately paid for its construction without debt. This brand-new f
mises.org
Word spread and many uninsured patients came to our facility, along with patients with high-deductible health plans and HSAs [health savings accounts]. Most of the Division I athletes had their surgery at our facility, and our reputation in the community grew more solid every day. Dr. Lantier and I were both trained in pediatric anesthesia and particularly enjoyed this part of our practice. Nothing better builds the practice of an anesthesiologist than the careful anesthetic treatment of someone’s child.
The area hospitals hated us because patients could buy their surgeries at our facility for less than their insurance deductible at the hospitals.
Paradoxically, no insurance companies would work with us.
We would not understand any of this until much later, when our posted prices clarified this for us. We were very busy and very successful, early on. Within six months, I was distributing sizeable profits to the partners monthly, while usually charging one-tenth what the hospitals were charging for the same service. We added to our “quote over the phone” price list every week, so patients could have an answer to their price question immediately.
----
It was no surprise to us that the hospitals were the first to attack us. They attacked us directly by attempting to ban physician ownership of facilities in the state. This was done under the banner of trauma care, the hospitals falsely claiming that if surgeons owned their own facilities, they would not treat trauma patients. No one knew, including me, that when the state legislature created the state trauma task force the underlying mission was to close physician-owned facilities. A Democrat legislator who saw us as an underdog, a champion of the poor, told me with a wink and a nod that I needed to be on this task force, a business-saving favor he and I have since acknowledged. Our facility, and another that had copied our model, were the obvious targets of this task force and surprisingly there was no plan in place if representatives of either of our facilities argued our case in person. Our unexpected invitation and inclusion in this wannabe Star Chamber derailed their plans to ban our existence.
----
Because patients could pay the entirety of the cost of their care for less than their deductible and copay at in-network area hospitals, the insurance companies, paying us out of network, received intense pressure from the area hospitals for this lost business. Likely threatened with retaliation in the form of higher prices billed to the insurance companies by these hospitals, the insurance groups began stacking deductibles, a process where patients going out of network had to meet their in-network deductible, then start again at “zero” to accumulate any out-of-network benefit. This deductible stacking put our facility out of financial reach of most patients who were insured who would otherwise rather pay us directly. Our waiting room was empty, and we faced closure. Up until this point we had grown so rapidly that we had built the large facility we now occupy, and fortunately paid for its construction without debt. This brand-new f
Why Aren't There More Free Market Surgery Centers and Clinics? | Mises Institute
Just over twenty-four years ago the Surgery Center of Oklahoma began with a simple mission: deliver the highest quality of care at a reasonable and
