Archive for December 22nd, 2013


How to manage health care

December 22, 2013

I’ve mentioned price transparency for health care before. This article in The Freeman describes a surgeon who’s making it happen. And he confirms my long-held idea that what makes medical care so expensive is all the paperwork and overhead.

Can This Man Save Healthcare?

While the country focuses its attention on the sputtering implementation of the Affordable Care Act (ACA), one man is quietly revolutionizing American medicine. Dr. Keith Smith, founder of the Surgery Center of Oklahoma (SCO) in Oklahoma City, is bringing market forces to healthcare by posting his prices online.

Healthcare costs in the United States have increased at an average rate of 7.7 percent per year since 1980, compared to 4.6 percent for the consumer price index. Smith believes price wars and other market mechanisms, not increased government control, are the best way to stem and reverse this inflation. With the ACA’s implementation, the prospects for formal healthcare policy changes are limited. Smith hopes, however, that he and a handful of other transparent fee-for-service providers will be the vanguard of a free-market movement that runs parallel to the ACA. “The price transparency and price deflation,” Smith says, “aims at the soft underbelly of the beast.” […]

Healthcare Doesn’t Cost That Much

According to Smith, “Healthcare doesn’t cost that much, but what healthcare professionals charge is another matter.” By cutting out hospital administrators and the bureaucracy involved with third-party payers, the SCO is able to offer healthcare services at deep discounts. For example, for a patient with a bad back, the SCO was able to perform a two-level disc decompression for $8,500. That paid for the surgeon, anesthesia, and supply costs as well as an overnight stay. The patient’s next-closest bid was $60,000, saving his company’s health plan $51,500. While few would argue that high four- to low five-figure treatment costs are cheap in absolute terms, in relative terms they are. For major spine surgery, the SCO charges $16,500, which Smith admits “is a lot of money, but people are flying here from Alaska and Massachusetts to get this price because in their home states it’s not uncommon for this surgery to cost $175,000.” […]


Five reasons

December 22, 2013

Here’s a very interesting article from I’ve kept their five reasons but omitted the specifics. If you’re intrested, RTWT.

5 Reasons Why 2013 Was The Best Year In Human History

Between the brutal civil war in Syria, the government shutdown and all of the deadly dysfunction it represents, the NSA spying revelations, and massive inequality, it’d be easy to for you to enter 2014 thinking the last year has been an awful one.

But you’d be wrong. We have every reason to believe that 2013 was, in fact, the best year on the planet for humankind.

Contrary to what you might have heard, virtually all of the most important forces that determine what make people’s lives good — the things that determine how long they live, and whether they live happily and freely — are trending in an extremely happy direction. While it’s possible that this progress could be reversed by something like runaway climate change, the effects will have to be dramatic to overcome the extraordinary and growing progress we’ve made in making the world a better place.

Here’s the five big reasons why.

1. Fewer people are dying young, and more are living longer. […]
2. Fewer people suffer from extreme poverty, and the world is getting happier. […]
3. War is becoming rarer and less deadly. […]
4. Rates of murder and other violent crimes are in free-fall. […]
5. There’s less racism, sexism, and other forms of discrimination in the world.

I have a few differences with the author:

  • I’m not worried about inequality of outcome so long as equality of opportunity still applies. While I don’t think it always applies everywhere, I think it’s true more often than not. Let’s not make the Perfect the enemy of the Good.
  • Neither am I worried about the "deadly dysfunction" of a government shutdown. Democratic partisans like to ignore the fact that passing sweeping legislation (Obamacare) on a strictly party-line vote will always result in determined opposition from the other party. (No Republican representatives voted for the bill.) But if the roles were reversed, then Democratic partisans would be lauding their own obstructive efforts as The Will Of The People or whatever.
  • I’m not too concerned about "runaway climate change" and my guess is that many who are concerned now will change their minds later.
  • He neglects to mention that deaths from cancer continue to fall in the U.S.

Overall, I think the article highlights some very positive trends. There are always so many people using Fear, Uncertainty & Doubt to promote their agendas — and so many fans of Apocalypse Porn — that it’s very easy to ignore all the progress that’s being made.

After you read the ThinkProgress piece, check out the Cato Institute’s site for more in the same vein.

And Happy New Year!

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