Mises Wire

In Healthcare, a Little Bit of Market Freedom Goes a Long Way

In the US, a hysterectomy or a gall bladder surgery can set you back tens of thousands of dollars. For families that do not possess medical insurance or have inadequate coverage, it can be financially stressful to visit a hospital or schedule an appointment with a doctor. Most people residing outside the US would suffer sticker shock since they receive medical treatment for free at the point-of-service, though their taxes are through the roof. Indeed, the US does have an affordability issue. Is this the result of free market economics, or is there something else to it?

A Retail Surgery Shop

When you walk into your physician’s office or a hospital and receive medical care, you are unlikely to know the cost of the visit. If you are insured, the administration will just bill your provider or, if you are subscribed to a government program, a subsidy will pay for your appointment. This produces myriad problems but primarily pricing opacity. One hospital in Oklahoma City is changing that.

In 2004, Dr. Keith Smith and Dr. Steven Lantier founded the Surgery Center of Oklahoma (SCO), a medical facility established on the idea of price honesty. Four years ago, the organization began posting a detailed list of all-inclusive and guaranteed pricing. If there is one thing these medical professionals have learned over time, it is that “healthcare really doesn’t cost that much” but “what people are being charged for is another matter altogether.”

If you undergo a breast biopsy at SCO, you can expect to pay $3,500. Anywhere else, you would pay more than $16,000 for the same procedure. Do you need an ankle arthroscopy? It will cost you just under $4,000 at SCO, compared to about $23,000 in other parts of the country. If you tore your patella tendon you could expect to be faced with a $30,000 medical bill, but walk into the Oklahoma establishment and you’ll pay a fifth of the price.

Using economic principles, these two doctors aimed to transform the local healthcare sector through price transparency and bidding wars. It has worked out quite well, as a whole host of institutions have gradually mirrored SCO, including the Oklahoma Heart Hospital, Breast Imaging of Oklahoma, and McBride Orthopedic Hospital. To avoid burdensome regulations, some facilities have announced that they do not accept Medicare and Medicaid — something that has recently become more common. Dr. Smith told Conservative Modern,

Hospitals are having to match our prices because patients are printing their prices and holding that in one hand and holding a ticket to Oklahoma City in the other hand and asking that hospital to step up. So we’re actually causing a deflationary effect on pricing all over the United States.

In recent years, there many smaller clinics across the country have been adopting these kinds of models. Even Walmart, which has entered the healthcare business, is offering low-cost care. When you walk into some of these offices, you see a board on the wall that lists prices for everything from a physical examination to a flu shot or an x-ray. These establishments are usually cash only. So, if these outlets are implementing such practices, why can’t the entire industry do it?

An Anatomy of Healthcare Economics

Healthcare price inflation has skyrocketed since the 1970s. What, then, has been the main driver of this tremendous surge in medical care costs? The two most despised institutions in society: insurance companies and the government.

Back in the day, insurance was only purchased for catastrophes such as cancer, heart attacks, and life-threatening surgery. Today, patients buy health insurance for benign medical matters, from the common cold to the flu shot. Rather than pay out of pocket for these services, either the insurer or the state foots the bill, which means patients are more willing to go through tests and exams that might not even be necessary. When price transparency is eliminated from the equation, people take advantage of the system. When directly impacted by prices, though, the public is far more willing to shop around, price match, and do what is best for the pocketbook, much as it does with other goods and services.

Put simply, if you are paying for healthcare directly, you will ask: how much will this cost? Unfortunately, trying to determine the cost of both routine and more intricate services can be nearly impossible. Even if you were to ask, medical clinics would likely be unable to answer your inquiries; they are already spending about one-fifth of their earnings on administrative staff just to file insurance paperwork.

It is true that bills may vary per patient. One individual might be overweight and older, with a preexisting condition. Another person might be young and in shape, with zero medical complications. The former has vastly different needs from the latter. That said, home renovators can provide quotes for homes of different sizes, shapes, and ages. A restaurant can put together a menu with prices for each dish. A dentist or optometrist can be specific in what he or she charges. But in general medical care, it is impossible. When this is the norm, it is extremely difficult to influence providers to lower their premiums.

A Free Market Failure?

Leftists will shriek to the heavens that the US healthcare system is a free market failure. There are two things wrong with this statement. The first is that American healthcare is among the best in the world for serious chronic illnesses, which is why people flock there from all over the world to seek medical care. The second is that it is not an authentic free market system. The main problem with US healthcare is that there are far too many regulations, rules, and restrictions imposed by the government. When you add in state subsidies, an insurance industry built on cronyism, and doctors buried in paperwork, you have a mess of a system.

The Surgery Center of Oklahoma is a prime example of what free market health care looks like — and it is far superior to hallway healthcare in Canada and long wait times across the pond.

Originally published at LibertyNation.

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