Surgery Center of Oklahoma Blog

Like Dr. Ron Paul and everyone paying the 3% tax on their income for Medicare, I would like to see Medicare abolished.  This cannot be accomplished suddenly, however, as so many people are accustomed to living on the dole and the market would need time to react to this radical change.  I have suggested in a previous blog that one way to get there would be to send this Ponzi scheme to the states for them to deal with as they see fit.  Some in D.C. have suggested that the program continue, but be “means tested.”

I thought of this while at a college football game this weekend.  Having donated to a major university, my family was eligible to purchase seats in the “club level.”  This donation was significant.  I was struck at our first game with how many elderly folks were in the “club level.”  I started wondering how many of them would flinch or gripe about means testing Medicare.  I started thinking that spared the expense of health insurance or health care, they were able to buy these very expensive tickets to the game.  I began to wonder if these elderly folks realized that their grandchildren were actually subsidizing their football habit.  I thought of the grief that Dr. Tom Coburn has been given for even suggesting that means-testing federal entitlements like Medicare should be considered.

Most families are paying $1000-1500/month for traditional health insurance.  Many are not aware that this is the actual expense, as their employer pays a substantial amount of this bill.  This comes right out of the employee’s paycheck, however, one way or another.  This amount of money is more than enough to pay for a donation sufficient to “join the club” at the big university and purchase tickets at the 50 yard line.

Major university football teams and diesel motor home makers are not the only beneficiaries of this distortion of the market made possible by the robbery of the young working folks for the benefit of the older retirees.  The list of beneficiaries of this mal-investment is too long for this blog.

There is no market based insurance product for the elderly.  Medicare has no competitors.  Right now the elderly have no choice but to accept this program, other than to reject all insurance, an option that is scary for all but the extremely wealthy.  I hope the day will come when the elderly demand that this Ponzi scheme stops.  Medicare’s demise won’t  happen any other way, in spite of the efforts of well-meaning folks in D.C.

G. Keith Smith, M.D.

First a geography lesson.  Guthrie, Oklahoma is a quaint little town north of Edmond, Oklahoma.  Edmond is a northern suburb of Oklahoma City.  The initial flight from Oklahoma City was to Edmond.  The later flight for tax and school reasons has been to Guthrie.   Claremore is a suburb of Tulsa to the south (it is also the birthplace of Will Rogers).  Back to these little towns momentarily.

Imagine that two vampires are fighting it out for your blood.  I know.  It’s not Halloween yet but stay with me. This is not like two businesses competing for you because they want your business…competition that you will benefit from….this is for your blood.  You will be drained and worse off, no matter who gets to sink their teeth in to you.  Bottom line:  this is not about you, regardless what sales pitch The Count gives you about the benefits.  That pretty accurately describes the fight between two hospitals for the health business originating from Guthrie, Oklahoma.  It also describes the struggle between two corporate health giants over the south part of Tulsa and nearby Claremore.  This is not the stuff the free market is made of.

Now put yourself in the shoes of the Sisters of Mercy, for a moment.  Extremely profitable business from Guthrie has traditionally come to your hospital in Oklahoma City.  A competing hospital group builds a new facility in North Edmond (just south of Guthrie).  Ouch.  What do you do?  Well, if you have billions of dollars in the bank from years of “not making a profit,” you….ready?….buy Guthrie!  You buy their hospital. You buy their physician clinics.  You buy everything medical you can get your hands on.  You do this because your competitor has a history of setting up clinics and hiring the local doctors and basically draining the medical life out of a small town and hospital before moving on without remorse to the next victim.

The same thing is going on between two giants in Tulsa, with the town of Claremore acting as the host.  Hillcrest Hospital actually bought Southcrest Hospital and installed their one of their competitor’s henchman at the helm as the new administrator!

What do these purchases have in common?  They illustrate the buying power of these “not for profit” barracudas that have fleeced Oklahomans for years.  They illustrate how far these outfits will go to protect their turf.  They represent a “give away” of facilities that have been built or subsidized by taxpayers for years, even decades, to these giant hospital systems.  I wonder if any of the councilmen or county commissioners authorizing these sales will end up on the boards of these big hospitals?

I foresee that these small hospitals will only serve as a short and limited meal for  these blood suckers.  That has certainly been the pattern in Oklahoma.  A giant hospital opens a clinic in a small rural Oklahoma town and, “Presto!” all of the patients end up in Oklahoma City or Tulsa, decimating the previously solvent small town hospital.  Any patient that needs a surgery or procedure that makes money for the mother ship will be transferred to Oklahoma City or Tulsa.  Only the very sick and bed-ridden will be left in these small hospitals, having been essentially transformed into nursing homes.  It will soon be clear that having stripped away and devastated these now un-dead hospitals, they will not be able to continue to exist without the support of the giant corporation.  The big hospitals will then advertise this subsidization as a community service, never acknowledging that this devastation was their goal all along.  Ideally, for the Sisters of Mercy, Guthrie Hospital would close completely, leaving the referral fangs embedded in their community with “wellness” clinics and hired doctors.  Add the electronic medical record scam to this and the people of Guthrie will be more easily controlled and hearded to whatever destination suits the Mercy folks the best.  Same goes for Hillcrest.

Physicians in these smaller communities will experience the “Mercy Mission” first hand.  A local pediatrician actually said she was looking forward to this!  The local doctors will be told that “now that Mercy owns their clinic, that Mercy is the new landlord and here are your new rental rates”…they will be very high, or, Mercy won’t lease space to them at all if they don’t succumb to the “job offer.” ” And, by the way, you can either come to work for Mercy as an employee or we will make sure that all of these referrals for gall bladder or ear surgery go to Oklahoma City.  Oh, one more thing, we aren’t going to pay you enough to make ends meet so you might as well close your practice…we are going to send all of the business that makes us boatloads of money back to the mother ship anyway.”

What does Guthrie’s medical community look like 5 years down the road?  If you said the same as Claremore’s you go to the head of the class!  Small town hospitals have a difficult enough time as it is with their demographic of elderly and poor.  Add these opportunistic neck-biters to the picture and they don’t stand a chance.  Add their hostile physician practice takeovers and you have the answer to why small towns have trouble recruiting and keeping physicians.

G. Keith Smith, M.D.

“The needs of the many outweigh the needs of the few.”  If you are not a Star Trek fan you just need to know that this is what Mr. Spock said to his captain (Jim Kirk) when he volunteered for a suicide mission that would save the rest of the crew.  Back to this shortly.

Years ago I was pressured to release the confidential medical records of patients operated on at our facility.  I didn’t release the records and it got very ugly, but ultimately we prevailed.  During the very threatening discussions a physician who was a hired gun by the folks who wanted these records told me that patient confidentiality was not important if this data collection made a difference in someone else’s life.  I argued that individual rights distinguished our form of government from those that championed the “collective.”  I tried to point out that a possible benefit to one individual doesn’t justify the violation of the rights of another.

He quoted Mr. Spock, as I have above.  I pointed out that Mr. Spock’s actions were those of a volunteer.  ”It is one thing to throw yourself on a grenade to save your foxhole buddies.  It is quite another to be shoved onto the grenade against your will,” I said.  This hired gun still didn’t get it.  We wound up filing a lawsuit against this bunch of fascists and the patients’ data remained secure.

What’s the point of all of this? 

Everyone wants your health information.  Your employer wants it.  The government wants it at the state and federal level.  Private companies are offering chips onto which your health history, allergies and medications can be stored so that you can basically carry a detailed medical record with you at all times. 

My advice is to be very careful who you share your personal health history with.  It is not out of the realm of possibility that governments would subpoena data you have revealed to a private entity.  The consitution-ignoring thugs in D.C. have already done this with cell phone records.  Once your health information becomes digitalized, it is not nearly as secure as it was on a paper record.  Paper medical records are much more difficult to steal and organize into the much desired statistical justification for anything and everything that will be a recommendation from D.C.  It is probably no coincidence that the feds are providing incentives to physicians and faciltiies to convert to digital medical record systems.  Physicians and facilities that do not convert will be singled out for lower payments from Medicare, for instance.  Health information technology businesses have made billions because of these boosts in demand created by our wonderful government that simply were not there before.  Watch for certain congressmen and senators to have high paying positions on the boards of these companies after they leave office. 

Make no mistake.  The individual’s right to privacy with regard to their health records is under full assault and this attack will likely continue for some time, particularly with the disaster of a national health plan looming.

G. Keith Smith, M.D.