Surgery Center of Oklahoma Blog

Hugo Chavez, the socialist dictator of Venezuela, went to Cuba to have his cancer operation recently.  I figure this makes him a medical tourist.  His trip to Cuba for medical treatment raises many questions, too.

First, why not have his treatment/surgery in his own country?  Maybe because the care there is…well…awful.  Yes, I said it.  Check out this article on health care in Venezuela.  “But the health care in Venezuela is free,” you say.  Of course, nothing is free.  And apparently what care you can receive there is of such poor quality that this man opted to become a medical tourist.  He’s not the only government thug who has done this.  Check out this article on one of the Canadian bureaucrats, Danny Williams.

Second, why Cuba, of all places?  This is perhaps the most interesting part.  Apparently his surgery was done in Havana, but there is no listing of the hospital or facility.  Cuba has a large medical tourist business but none of these facilities are available, of course, to the locals, since their health care is…well….you know, free.  Or, was Chavez simply afraid that a Venezuelan anesthesiologist might not wake him up?

Third, who paid for his care?  Whoa, wait a minute.  His treatment in Venezuela would have been “free.”  It is illegal (just as it is in Canada) to pay out of pocket for care outside of “the system.”  Do you think he paid for this care himself?  Right!  I guarantee you the Venezuelan government (Venezuelan slaves)  paid for his care, just as the Canadian government pays for their bureaucrat’s care when they come to the U.S.  Wait, you don’t think that the Cuban facility did this operation for nothing do you?  Hah!

Fourth, doesn’t he know that he could have received free (I mean absolutely free) care from any number of medical tourist destinations that would love to have held their facility up as the preferred medical destination of the world’s richest and most powerful?  I think that some of the international medical tourist destinations might have even paid him to have his procedure at their facility just for the bragging rights!  But then, he’s a socialist and probably didn’t think about that.

If the purveyors of Obamacare all have their way, they may get to be medical tourists, too.

G. Keith Smith, M.D.

Here in the old USA and also in other countries there are companies that help people find affordable health care.  The Surgery Center of Oklahoma is one of the premier and favorite destinations of those individuals needing surgery and those companies that help individuals find high quality and affordable care.  Those seeking this care generally fall in to one of the following categories:

1)Uninsured here in the U.S.(this category also includes those with such high deductibles that they will be paying for the whole thing themselves).

2)Foreigners (mostly Canadians) not willing to wait on a list (usually years) to have their surgery within their broken-down socialized system

3)Foreigners whose home country has poor or unavailable care.

Let’s start with the easy one…#3.  If you have money and you have a hernia, you would naturally travel to another place to have surgery if care was unavailable where you lived.  This is perfectly understandable and no different than if you lived in a rural community and drove “to the city” to have your brain tumor evaluated by a neurosurgeon.  We have had patients come to our surgery center from Africa because they had to travel anyway and they figured they might as well come to a place where they knew what it would cost.

Now let’s try to tackle #2.  First of all, what does it mean that people who live in Quebec or Ontario or Vancouver or Montreal (big cities with every medical specialty and subspecialty represented) come to the Surgery Center of Oklahoma for their care?  What sort of system is in place when an ear nose and throat surgeon whose office is across the street from your Vancouver town home (and who is not busy!!) is shunned for an ear nose and throat surgeon in Oklahoma City, thousands of miles away?  What other evidence do we need that the Canadian styled system has failed?  Are the Canadian doctors any good at what they do?  Yes they are, without a doubt.  Are they working hard?  No.  The Canadian government has limited what amounts of money can be spent on care (regardless of demand) so when the money runs out the physicians and hospitals stop working.  ”There’s no more money for hernia surgery this year, Mr. Jones.”  ”There’s no more money for coronary artery bypass surgery this year, Mr. Williams.”  I have heard this story countless times.  Compounding the problem is that the Canadian people have been brainwashed into thinking that their care is “free.”  This combination of “free” care with deliberately stifled supply has caused such an imbalance of supply and demand that people are waiting in line for surgery.  For years.  Watch the video on our Media tab of the poor woman who came to Oklahoma City from Canada to have her hip replaced to get a feel for what she went through.

So, many of the Canadians come here.  Some find us on their own.  Some find us through brokers or companies that help these patients escape the wait.  What effect has this competition had on the Canadian system?  Not only have the wait times shortened for these patients due to the leak of surgical patients into the U.S.(and the incredibly bad press this has caused for the politicians in Canada), but the prices charged Canadians by the facilities along the border have fallen.  Much of the revenue of hospitals on the U.S. side of the Canadian border come from Canadians willing to pay for their surgery in order to avoid the lines at home.  The pricing at physician-owned facilities here in Oklahoma (hats off to the Oklahoma Heart Hospital and the McBride Clinic Hospital for helping their share of these folks!) like ours have made the prices more competitive along the border to the benefit of the Canadians, as these border hospitals count on this revenue and are not wanting to lose this business.  I think this is  a great example of how true competition disciplines the service providers to the benefit of the consumer.

Ok…ready for #1?  This is the really hard one.  Medical and surgical care in the United States is of fairly uniform quality no matter where you go. What?  How can this be?  Why would people travel from Alaska and Maine to Oklahoma City for their surgery then?  Price.  Guaranteed Price.  The provision of quality care is not because of accreditation agencies or state health departments or federal rules and regulations.  The delivery of quality medical care is the result  of the small remnant of the free market that while whittled down and beaten down here in the U.S. still wields unimaginable power.  If you are awful in this business you will go bankrupt, as it should be.  Once you socialize care (government care) the worse you will become but ironically…..ready?….  the more money you make!  What?  Just look at any government program (including public schools and banks).  The worse the performance the more money thrown at the problem.  Not so in the private sector.  If you want to find real quality and value look for places where there is real competition and a vital entrepreneurial spirit….that’s where you will find quality.  Because the folks and facilities in that environment who are no good….well…they are already gone!…out of business.

The entrepreneurial spirit amongst physicians here in Oklahoma is alive and well.  The care delivered in this part of the country is second to none because of the healthy competition within the medical community.  The private practice, rugged individuality still prevalent here makes us all better than we would be were we practicing in an environment where the patients were captive and had to come see us and were without choices.

So…Maine….Alaska…Florida…California…good luck keeping up with us on the quality front.  Until you post your prices, though, your facilities will continue to lose business to those of us who do post them and practice in a competitive environment.

G. Keith Smith, M.D.

This past week 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.