I once tried to get a base estimate from a hospital. Lady told me it was illegal to give that information. And if a hospital gives terrible care there are no repurcussions.
If bread was distributed through insurance, it would cost $50 per loaf and there'd be a waiting list. Also, the baker would decide what bread you need.
In Hungary, besides the government hospitals, there are many many private clinics performing modern surgeries, and having fixed price lists. On a vacation I paid about $120 for a 15-minute scalpel local anesthesia outpatient surgery, had an appointment for the next working day after I called the first time, without being an "established patient". No insurance needed, no preapprovals. US doctors first look for unrelated illnesses like cancer, then maybe a few months later they examine me for the illness in the actual symptoms. Not them at the private clinics in Hungary.
Loved this interview. Thanks for having the doctor back on. What he’s accomplished is amazing and should be replicated all of the country, and the world.
Dr. Smith has a wonderful (old) article on mises. Keywords to find was Giant Hospital Bill or something. It was fundamental in my understanding of "claims repricing."
People need practical things like this to believe that the free market is the best option. If we focus on the example of Dr. Keith Smith, I think a lot of people will accept the free market, especially since it is a sensitive issue for most people and is always used by the left as a main argument against the free market. I think it is necessary for Dr. Smith to appear with Tom Wood and Dave Smith.
had 3 surgeries in 1 day at his center you pay- they cut- your done pretty simple. all my doctors are young because I'm old and they are convinced they will not make any money if they go cash only or get sued to to death if something goes wrong. also most people have been brainwashed into thinking they have to have insurance. how many times have you heard people say "it was free because insurance payed for it"?
Unlike most other businesses, hospital and medical treatment has a billed price completely different from what the insurance company actually pays. The insurers get off paying a much MUCH discounted rate, whereas the person with no insurance is billed at a much higher price. Recently I had some extensive treatment and the raw bill price was about 20K. In the end though, the insurance company and medicare paid much less, and I paid only a few hundred. But an uninsured person walked for the same treatment he would have paid much more than me, or my insurance provider.
@@theronwolf3296 Some hospitals are happy to give you a rate between the bill and the negotiated rate the insurance company pays. The kicker is that Medicare participants (hospitals) receive a percentage of their uncompensated care from the federal government (according to Dr. Smith), so there is an incentive to make sure that the bill, if unpayable, is as large as possible.
Voluntary free markets always perform best. After all, in a free market, there's nothing to preclude a charity or coop or local government from creating a community health care center. If the local people vote to tax themselves for their own local care, that's fine. Like everything, the problem occurs when it gets too big and government controls too much and then all the alternatives that keep prices down and improve progress are lost.
I just had my second home birth. The first birth through a birth center cost me $6580. The second, through a different midwife business, cost me $5850.50. No surprises. I got to snuggle with my babies and not stress over insurance and billing.
Lets go!! Love that you interviewed this man this is going to be one of my favorites o can tell. Everybody wants health care solutions and he is solving a portion of it!
The health insurance companies are for profit, so they want their 20% cut of premiums to go up. And every year it goes up. When a hospital has 60% of customers are from one insurance company, they effectively own the hospital. Then the insurance company negotiates in such a way to make sure costs go up every year so that the premiums go up every year, and then the insurance company gets to keep 20% of the total premiums. They want their 20% to go up every year, so they make sure costs go up every year. Health insurance companies are the most corrupted and dirty corporations that you would ever believe. It doesn't matter if a surgery costs 5k, it has to cost 10k because it costed 9k last year, and the insurance company wants their costs to go up and their premiums to go up, and when the premiums go up, their profits go up!!!! FOR PROFIT INSURANCE COMPANIES ARE CORRUPT. If we legislatively eliminated for profit insurance companies and we doubled the number of doctors, are you telling me America would have these same problems? not at all. Doctors in the USA get paid more than any other country on the planet, and we need to fix this.
Fantastic interview Freedom-Doctors in Sturbridge Massachusetts is attempting similar things for primary care but finding issues not being able to refer for anyone with a HMO plan… hopefully there will be more options like this in our area.
I don't think the specific cardiac hospital can withstand the libertarian scrutiny Dr. Smith proposes here. They don't have a good reputation financially.
This topic as well as re-industrializing America are top subjects in our zeitgeist.. terrifs on foreign goods means we have to produce it ourselves.. 3D printing with AI help in durable materials is a super exciting field of study.. keep up the great work..
Free market seems best for many things, but for the more rare conditions it seems like there would be much less incentive to research. But it's obvious the more centrally controlled, the less quality
I assume you are speaking about pharmaceuticals. In my humble opinion, that is not true. The question is whether the companies will be rewarded for their research by allowing them to set their prices. There has been a lot of shift of focus towards rare diseases and successful outcomes. Americans need to realize that one of the reasons why drug prices are so high in USA is that the USA is subsidizing a lot of other developed nations in the EU, UK and other parts of the world. If there was freedom to price, then prices would rise in these places as they are artificially kept low through regulation. Accordingly, the prices in the USA would reduce because these companies would not be relying only on the Americans to recoup their research cost and generate a profit. A strong foreign policy push to correct this should also be on the agenda. Best regards
@aayushpoudelNP understand but if a disease is rare, unless it inflicts the very wealthy, where would the money come from? A relatively few, not so rich sick people wouldn't have the funds to provide the incentives. However, I would like to think that in a more abundant free society (where resources aren't mostly wasted by gov) there would be more people able to harness their creativity
@aayushpoudelNP right but with the case of rare diseases, what entities would invest in research n treatment if the expected return is to b much less than the investment ( on a strictly monetary incentive mindset. Although in reality people do get non monetary returns in the form of recognition and personal satisfaction from helping others...but the big money from business is focused on the "bottom line"). However, it's not like rare disease gets a meaningful portion of gov funds allocated to other conditions such as diabetes, cancer, etc.
@@Richard-ki4nkgm There are already many entities that invest in such research. While there are too many rare diseases to speak about all of them, I can provide you with relevant example. Multiple Myeloma is a rare blood cancer that was almost a death sentence with terminal timeline of less than 2 years. However, advancements in treatments, such as Bristol Myers Squibb’s Abecma (idecabtagene vicleucel) and others, have significantly improved outcomes. Although we all would like that treating diseases is quick, easy and cheap; life is not a fairytale. The reality is that research, development, especially of high quality costs money. Biology is complex and not fully understood. Many people need to pay attention to many different things and collaborate to get it all together. All these things require resources, time, effort and teamwork. How exactly are people supposed to engage in these kinds of activities if people don't value its worth? How will they not only cover their operational needs but also save some for the future? The "bottom line" is what fuels future investments in other areas. The story of the goose and the golden eggs come to mind. There is no such thing as a strictly monetary mindset. Monetary considerations is always secondary in economics, the primary consideration is the availability of goods and services that people voluntarily trade with each other. The only way to get more affordability and access is to remove hurdles to voluntary collaboration and increase the goods/services available (which results in increased prosperity).
I know a lot of people are complaining about healthcare and the denials and delays etc… But I e if my main needs is that we, the patient have little to no control over anything other than paying the bill when it comes. For example, the anesthesia for my last colonoscopy was denied and I was handed a bill for $1600. Was there a different type of anesthesia the doctor could have used? If so, why did t the doctors office (who did the pre authorization for me) use the alternate method instead? If health insurance companies expect you to do procedures and surgery without anesthesia (considering it an optional luxury) then why was that I do not brought to my attention so I could choose not to do the procedure (since it was a screening only) so as not to get sacked with the large bill? It’s like we’re all sitting ducks paying into a system that uses and abuses us at will.
This is because of licensure. There is no clear path towards delivering more variety and value without state licensure. This is likely due to an inability for 18th century court systems to handle the medical suits of a modern, industrial economy and population.
and he is the entire reason this conversation is happening right now. he sacrificed his freedom in the hope that Americans can go to the doctor again without worry. you are old and on Medicare, good for you. for the rest of us the system is trash, i got quoted $640 for a simple eye drop for my pink eye, it’s bullshit
Just goes to show the free market always finds a way...even amidst the government being obstinate. Any opinions out there how a model like this would translate to inpatient medicine (EM/HM/CCM). I am an intensivist and have been following Dr. Smith since I first heard about his model via Dr. Michel Accad. I have long wondered how we could implement a model like this on a large, inpatient scale for generally non-procedural services.
capitalism is not the problem, Bob! My God, how could you listen to Keith and conclude so wrongly? As Keith said, the lack of a free market is the problem! This will be my last visit to your channel. Your have a turn left sign at the top of your brain's flow chart.
I once tried to get a base estimate from a hospital. Lady told me it was illegal to give that information. And if a hospital gives terrible care there are no repurcussions.
My favorite economist interviewing my favorite doctor----youtube videos can't get better than this!
If bread was distributed through insurance, it would cost $50 per loaf and there'd be a waiting list. Also, the baker would decide what bread you need.
And add plenty of powdered chalk and sawdust to the dough.
Bakery would be licensed too
In Hungary, besides the government hospitals, there are many many private clinics performing modern surgeries, and having fixed price lists. On a vacation I paid about $120 for a 15-minute scalpel local anesthesia outpatient surgery, had an appointment for the next working day after I called the first time, without being an "established patient". No insurance needed, no preapprovals. US doctors first look for unrelated illnesses like cancer, then maybe a few months later they examine me for the illness in the actual symptoms. Not them at the private clinics in Hungary.
Awesome interview! It's an absolute tragedy that we don't have a free market competition in health care.
I interviewed with Dr. Smith. Didn't work out but one of the best interview experiences in healthcare I've ever had.
Loved this interview. Thanks for having the doctor back on. What he’s accomplished is amazing and should be replicated all of the country, and the world.
Dr. Smith has a wonderful (old) article on mises. Keywords to find was Giant Hospital Bill or something. It was fundamental in my understanding of "claims repricing."
People need practical things like this to believe that the free market is the best option. If we focus on the example of Dr. Keith Smith, I think a lot of people will accept the free market, especially since it is a sensitive issue for most people and is always used by the left as a main argument against the free market. I think it is necessary for Dr. Smith to appear with Tom Wood and Dave Smith.
had 3 surgeries in 1 day at his center you pay- they cut- your done pretty simple. all my doctors are young because I'm old and they are convinced they will not make any money if they go cash only or get sued to to death if something goes wrong. also most people have been brainwashed into thinking they have to have insurance. how many times have you heard people say "it was free because insurance payed for it"?
Unlike most other businesses, hospital and medical treatment has a billed price completely different from what the insurance company actually pays. The insurers get off paying a much MUCH discounted rate, whereas the person with no insurance is billed at a much higher price.
Recently I had some extensive treatment and the raw bill price was about 20K. In the end though, the insurance company and medicare paid much less, and I paid only a few hundred. But an uninsured person walked for the same treatment he would have paid much more than me, or my insurance provider.
@@theronwolf3296 you sure said a lot but none of it made any sense
@@theronwolf3296 Some hospitals are happy to give you a rate between the bill and the negotiated rate the insurance company pays.
The kicker is that Medicare participants (hospitals) receive a percentage of their uncompensated care from the federal government (according to Dr. Smith), so there is an incentive to make sure that the bill, if unpayable, is as large as possible.
Voluntary free markets always perform best. After all, in a free market, there's nothing to preclude a charity or coop or local government from creating a community health care center. If the local people vote to tax themselves for their own local care, that's fine. Like everything, the problem occurs when it gets too big and government controls too much and then all the alternatives that keep prices down and improve progress are lost.
For instance, UHC owns the entire chain of care and has bought out most of the small clinics, pharmacies etc that compete.
@@homewall744 Why do you include local government taxes in your free market solutions?
I just had my second home birth. The first birth through a birth center cost me $6580. The second, through a different midwife business, cost me $5850.50.
No surprises. I got to snuggle with my babies and not stress over insurance and billing.
Lets go!! Love that you interviewed this man this is going to be one of my favorites o can tell. Everybody wants health care solutions and he is solving
a portion of it!
The health insurance companies are for profit, so they want their 20% cut of premiums to go up. And every year it goes up. When a hospital has 60% of customers are from one insurance company, they effectively own the hospital. Then the insurance company negotiates in such a way to make sure costs go up every year so that the premiums go up every year, and then the insurance company gets to keep 20% of the total premiums. They want their 20% to go up every year, so they make sure costs go up every year. Health insurance companies are the most corrupted and dirty corporations that you would ever believe. It doesn't matter if a surgery costs 5k, it has to cost 10k because it costed 9k last year, and the insurance company wants their costs to go up and their premiums to go up, and when the premiums go up, their profits go up!!!! FOR PROFIT INSURANCE COMPANIES ARE CORRUPT. If we legislatively eliminated for profit insurance companies and we doubled the number of doctors, are you telling me America would have these same problems? not at all. Doctors in the USA get paid more than any other country on the planet, and we need to fix this.
Very interesting interview, thank you both!
God bless you Dr.
Fantastic interview Freedom-Doctors in Sturbridge Massachusetts is attempting similar things for primary care but finding issues not being able to refer for anyone with a HMO plan… hopefully there will be more options like this in our area.
Thank you for this video!
I don't think the specific cardiac hospital can withstand the libertarian scrutiny Dr. Smith proposes here. They don't have a good reputation financially.
I hope he ends up on Joe Rogan’s podcast! These truths are game changing!
Great interview. HHS/Medicare is a racket.
This topic as well as re-industrializing America are top subjects in our zeitgeist.. terrifs on foreign goods means we have to produce it ourselves.. 3D printing with AI help in durable materials is a super exciting field of study.. keep up the great work..
Well nice to know im more knowledagble than ivy leauge students, tho also kinda scary at the same time.
Free market seems best for many things, but for the more rare conditions it seems like there would be much less incentive to research.
But it's obvious the more centrally controlled, the less quality
I assume you are speaking about pharmaceuticals.
In my humble opinion, that is not true. The question is whether the companies will be rewarded for their research by allowing them to set their prices. There has been a lot of shift of focus towards rare diseases and successful outcomes.
Americans need to realize that one of the reasons why drug prices are so high in USA is that the USA is subsidizing a lot of other developed nations in the EU, UK and other parts of the world. If there was freedom to price, then prices would rise in these places as they are artificially kept low through regulation. Accordingly, the prices in the USA would reduce because these companies would not be relying only on the Americans to recoup their research cost and generate a profit. A strong foreign policy push to correct this should also be on the agenda.
Best regards
@aayushpoudelNP understand but if a disease is rare, unless it inflicts the very wealthy, where would the money come from? A relatively few, not so rich sick people wouldn't have the funds to provide the incentives.
However, I would like to think that in a more abundant free society (where resources aren't mostly wasted by gov) there would be more people able to harness their creativity
@aayushpoudelNP right but with the case of rare diseases, what entities would invest in research n treatment if the expected return is to b much less than the investment ( on a strictly monetary incentive mindset. Although in reality people do get non monetary returns in the form of recognition and personal satisfaction from helping others...but the big money from business is focused on the "bottom line").
However, it's not like rare disease gets a meaningful portion of gov funds allocated to other conditions such as diabetes, cancer, etc.
@@Richard-ki4nkgm There are already many entities that invest in such research. While there are too many rare diseases to speak about all of them, I can provide you with relevant example. Multiple Myeloma is a rare blood cancer that was almost a death sentence with terminal timeline of less than 2 years. However, advancements in treatments, such as Bristol Myers Squibb’s Abecma (idecabtagene vicleucel) and others, have significantly improved outcomes.
Although we all would like that treating diseases is quick, easy and cheap; life is not a fairytale. The reality is that research, development, especially of high quality costs money. Biology is complex and not fully understood. Many people need to pay attention to many different things and collaborate to get it all together. All these things require resources, time, effort and teamwork. How exactly are people supposed to engage in these kinds of activities if people don't value its worth? How will they not only cover their operational needs but also save some for the future? The "bottom line" is what fuels future investments in other areas. The story of the goose and the golden eggs come to mind.
There is no such thing as a strictly monetary mindset. Monetary considerations is always secondary in economics, the primary consideration is the availability of goods and services that people voluntarily trade with each other. The only way to get more affordability and access is to remove hurdles to voluntary collaboration and increase the goods/services available (which results in increased prosperity).
I know a lot of people are complaining about healthcare and the denials and delays etc…
But I e if my main needs is that we, the patient have little to no control over anything other than paying the bill when it comes.
For example, the anesthesia for my last colonoscopy was denied and I was handed a bill for $1600.
Was there a different type of anesthesia the doctor could have used? If so, why did t the doctors office (who did the pre authorization for me) use the alternate method instead? If health insurance companies expect you to do procedures and surgery without anesthesia (considering it an optional luxury) then why was that I do not brought to my attention so I could choose not to do the procedure (since it was a screening only) so as not to get sacked with the large bill?
It’s like we’re all sitting ducks paying into a system that uses and abuses us at will.
This is because of licensure. There is no clear path towards delivering more variety and value without state licensure. This is likely due to an inability for 18th century court systems to handle the medical suits of a modern, industrial economy and population.
17:22.....Mangione is the "SUSPECT". He is not an "ALLEGED suspect"...He is actually the suspect
and he is the entire reason this conversation is happening right now. he sacrificed his freedom in the hope that Americans can go to the doctor again without worry. you are old and on Medicare, good for you. for the rest of us the system is trash, i got quoted $640 for a simple eye drop for my pink eye, it’s bullshit
If you trust the media and police in NY
Innocent until proven guilty & all that, maybe it would’ve been better worded as “alleged perpetrator” or something akin
Yes. All suspects are alleged. That was redundant and ungrammatical.
@ people misspeak, u understood what he wanted to say
Just goes to show the free market always finds a way...even amidst the government being obstinate. Any opinions out there how a model like this would translate to inpatient medicine (EM/HM/CCM). I am an intensivist and have been following Dr. Smith since I first heard about his model via Dr. Michel Accad. I have long wondered how we could implement a model like this on a large, inpatient scale for generally non-procedural services.
capitalism is not the problem, Bob! My God, how could you listen to Keith and conclude so wrongly? As Keith said, the lack of a free market is the problem! This will be my last visit to your channel. Your have a turn left sign at the top of your brain's flow chart.
They won’t miss you. How could you come to your conclusion.
What are u saying? bob & keith agree lol
Troll.
For-profit medical has got to be reformed.
Apparently you didn’t either listen to or comprehend this interview.
@@kenzeier2943 or it was sarcasm, which doesnt translate here, at all. or he was trolling. im leaning towards untranslatable sarcasm