President Trump began the likely long process of rolling back at least the majority of Obamacare during his first week in office, but some private doctors were way ahead in the affordable health care game.
An article in Time titled, “What Happens When Doctors Only Take Cash,” recently highlighted the cash-only payment practices at the Surgery Center of Oklahoma. Specifically, the article revealed that the costs associated with surgery can be significantly lower when a patient — or their employer — pays cash instead of using insurance.
In blatant contrast to most of the health care industry, Surgery Center of Oklahoma bills itself as a “free-market loving, price-displaying” surgical facility.
And its website further explains why these free market-loving doctors got into the cash-only business:
It is no secret to anyone that the pricing of surgical services is at the top of the list of problems in our dysfunctional healthcare system. Bureaucracy at the insurance and hospital levels, cost shifting and the absence of free market principles are among the culprits for what has caused surgical care in the United States to be cost prohibitive. As more and more patients find themselves paying more and more out of pocket, it is clear that something must change. We believe that a very different approach is necessary, one involving transparent and direct pricing.
Transparent, direct, package pricing means the patient knows exactly what the cost of the service will be upfront.
The Time article is an account of a patient’s savings by having a relatively routine surgery performed at Surgery Center of Oklahoma and paying cash over going to another hospital and having insurance pay. But it is also an account of a patient receiving quality of care the likes of which he had not ever experienced before:
A few days after Villa’s knee-replacement operation was completed on Jan. 17, his daughter captured a video of the happy patient, in headphones, “boogying down the hallway,” as he put it, of the Marriott Residence Inn in Oklahoma City, where he stayed for a week and a half to recover. After the surgery a physical therapist and a nurse visited Villa in his hotel room, bearing gifts: an ice machine, pain medication, a thermometer and detailed, hands-on instructions for his recovery, all of which were included in his original bill. “I’ve really never experienced this quality of care,” Villa says.
While I was never actually a patient at Surgery Center of Oklahoma, my almost surgery there has made me a fan and advocate for their model. After years of suffering gallbladder attacks, they had become serious enough to warrant surgery. As I had no insurance, I searched out options available to me. My choices were slim: an insurance plan on the health care marketplace and the subsequent deductible was unaffordable, so I was left with either enrolling in Medicaid or looking for affordable surgery.
The cost of gallbladder surgery (and most of the other procedures offered) at Surgery Center of Oklahoma is available online:
That cost, which includes post-surgery follow-up care, was less than the deductible I would have had to pay with an Obamacare marketplace plan. So, I scheduled my surgery for a few months out, in order to save up for it. Scheduling the surgery took me less than 15 minutes and one phone call, which included a full explanation of the pre-op and post-op care, and payment arrangements.
Unfortunately, my gallbladder had other plans and my surgery became emergent. With cost and my lack of insurance in mind, I checked out 45 minutes after my surgery in hopes of keeping costs to a minimum.
On my way into emergency surgery. Prayers most appreciated.
— Michelle Ray (@GaltsGirl) July 23, 2015
My final bill for the entire 3-hour procedure, from check in until check out, totaled over $27,000.
Emergency gallbladder surgery is pricey. Before Obamacare, I had insurance. Thank goodness they work w/cash patients pic.twitter.com/mmLp4qdBUN
— Michelle Ray (@GaltsGirl) August 13, 2015
While I was able to negotiate it down a great deal, I still wound up paying more than twice what the procedure would have cost me at Surgery Center of Oklahoma.
And to top it all off, I just finalized negotiations for the remaining bills for my surgery earlier this year.
Pay cash. They like cash.
— Michelle Ray (@GaltsGirl) December 23, 2015
While not every surgery can be planned in advance, a great number of them can be scheduled. And individuals and employers, alike, are discovering the savings afforded by Surgery Center of Oklahoma’s model. As Reason.com noted in a 2012 article about the center:
Self-funded companies, like individual patients, can negotiate directly with hospitals for lower prices. Recently a handful of self-funded Fortune 500 companies struck deals directly with major hospitals to care for their patients for a negotiated fee.
In Oklahoma City, there’s an alternative health care market taking shape in which hospitals offers competitive flat fee prices to self-funded companies. And it’s all modeled after the Surgery Center.
Surgery Center of Oklahoma isn’t the only free-market solution to health care, either. According to the article at Time:
In Oklahoma City alone there are roughly three dozen centers that are all or partly cash based, specializing in everything from radiology to oncology. Texas has two dozen such facilities, and in Torrance, Calif., the Ocean Surgery Center posts many of its prices online. Thousands of cash-based primary-care practices have also sprung up across the country.
Patients can learn about the laws governing primary care in their state and search for a primary care physician in their area by visiting Direct Primary Care Frontier.
Perhaps the benefits are best explained by the Reason.com video addressing how Surgery Center of Oklahoma manages to run counter to most of the health care industry in every way:
So while President Trump wrestles with Congress on how to go forward with regulating insurance coverage, many Americans are discovering a way to get affordable, high quality care: a free market.
Bonus: Surgery Center of Oklahoma accepts bitcoin!