In the early 2000s, Dr. John
Goodman, the father of Health Savings Accounts, used to ask why it was that we
would get emails from our local liquor store, but not from our doctors.
Fast forward to 2022, and a pandemic later, and we now get emails from our
doctors. A lot had to change, but doctors were finally getting paid for
telemedicine. The change was slow, and took a tragic set of events, but it
eventually happened. The rest of healthcare must eventually follow, but the path
for that change is unclear.
What we know is that someone, or some groups of people, will likely have some
cutting-edge ideas. They will have to pursue those ideas and business models.
And they will face adversity, and attacks from the powers that be telling them
that they are doing it wrong, what they are doing is impossible, and that it
doesn’t help line their pockets. They will be considered weird and strange, by
both their peers and the market. What we need are entrepreneurs to lead the way:
healthcare revolutionaries.
Fortunately, there are some of these crazy people already out
there – leading what is likely the future of the next healthcare revolution.
There is Dr. Keith Smith of the Surgery Center of Oklahoma, who – fed up with
the status quo – started posting his prices online. There is Dr. Josh Umbehr,
who – seeing the high burnout rate of his elder peers – decided to pursue a
newer business model that let him take care of his patients – instead of
insurance companies. There is Juliette Madrigal, who – fed up with the state of
healthcare – just started a cash only practice that she can fully control. These
leaders have now had others take up their business models and begin spreading
these models. These doctors from different areas of the healthcare system can
deliver at least some aspects of care for 90% less than their mainstream
competitors – and they can do it while providing higher quality.
It doesn’t stop there; the employer side of the market is starting to react.
Higher and higher healthcare costs are making employers face tough choices. They
can pay more for the same care – putting pay increases into healthcare instead
of their employees’ pockets. They can seek less coverage exposing their
employees to more risk. Or employers can seek out entrepreneurial solutions.
Service providers like Jay Kempton, a third-party administrator out of Oklahoma,
created a model where employees of his customers pay $0 copays if they go to
certain providers – like the aforementioned Keith Smith’s Surgery Center of
Oklahoma or the now numerous others that have now adopted Keith’s business
model. Some teacher unions have now followed suit. And others are following in
Jay’s footsteps, creating insurance models where clients pay $0 if they go to
certain places.
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Now that these models exist, all that is left is
for the market to start adopting them.
This change is going to take time – but it currently hinges on the
education and awareness of both doctors and employers. Doctors need
to know that these alternative models exist – and pursuing them can
be more lucrative and effective (they actually get to spend time
with their patients). Employers need to understand that although the
prices can be a magnitude less, the service is even higher.
The healthcare market is so broken that it is one of the only places
that you can currently get more for less.
Fortunately, this message is starting to catch on and there is even
one organization that is actively trying to get these two groups
together: the Free Market Medical Association. It is like a singles
bar for revolutionary healthcare providers. Practices that are
interested in finding out how to leave the control of the healthcare
insurance cartels while still being able to pay the bills. Employers
figuring out how to continue giving their employees access to
quality healthcare without continuing to pay the bigger and bigger
slice taken by healthcare middlemen. FMMA’s annual meeting is May
12-14th in Ft. Worth, Texas, this year and it is always a room full
of these revolutionaries – and people seeking solutions.
The prices in healthcare are out of control. The healthcare system
is broken. In large part that is the government’s fault, but it is
also complacency of both doctors and employers who aren’t yet
willing to innovate. However, as the market starts changing, and
hospitals start losing more money to reformers like Keith, more
companies and their employees are happier with Jay’s $0 copay, and
healthcare costs keep increasing, more and more changes will happen.
Hopefully, we don’t need another pandemic to
complete this change – we just need a few crazy entrepreneurs to
lead the way.
Charles Sauer is the president of the Market Institute, and the
author of Profit Motive: What Drives the Things We Do.
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