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Health Care Innovation

Opinion Editorial
October 8, 2009

By Jessica Peck Corry

Dr. Keith Smith is a proud capitalist. The anesthesiologist often helps poor patients obtain surgeries at no cost while managing to keep his Oklahoma-based practice afloat.

Speaking recently to a roomful of American reporters at a Vancouver hotel, Smith could have easily relied on lazy cliches to point out how Canada’s system fails its critically ill. Instead, he talked about something much more important to most Americans: how our system is failing us.

“The Canadian system is a Ponzi scheme that is just a little further along than ours,” he said, condemning what he called a “cartel” between U.S. hospitals and insurance companies, and condemning the lack of consumer choice present in both countries.

While speaking ill of the health care establishment, one of America’s most powerful political lobbies, might be enough to spell the demise for most medical professionals, Smith remains undeterred, accusing the two industries of often exaggerating each other’s expenses to generate greater public sympathy and more taxpayer funding.

“In the hands of a good surgeon, a tonsillectomy can take 10 to 15 minutes,” he said. “It’s criminal that this is billed out at $9,000.” He also expressed outrage that not-for-profit hospitals in his hometown made profits of up to $100 million in the last year alone and that more than 50 cents of every dollar spent on U.S. health care comes from taxpayers.

Smith is taking his campaign to lower medical costs directly to the public. As one of 40 doctors who together own and manage a successful outpatient surgery center that performs up to 60 procedures a day, he diligently works to keep costs low, providing savings to patients of up to 80 percent. His center is also the first in the nation to post prices for surgery packages directly on its website. “If we’re wrong on the total cost, the patient doesn’t eat the difference,” he said. “We do.”

Smith’s center succeeds without ever accepting any federal money. While his model is frequently attacked as one that can only benefit the wealthy, Smith disagrees, saying that more competition in the system will drive down costs for everyone.

A handful of Canadian patients benefiting from Smith’s services also took to the podium in Vancouver to share their firsthand accounts of participating in a cross-border experiment that is improving health care not only for Canadians, but also for a growing number of Americans willing to travel to other states to receive more timely and less expensive treatment.

“My hope is that Americans will start asking important questions,” said Smith. “They’ll start wondering, ‘Why did my insurance company send me down the street to that competitor, where the same procedure costs five times as much?’ ”

Partnering up with Smith is Rick Baker, a Canadian entrepreneur. The duo helps match Canadian patients with American surgeons, and to raise funds to cover the costs of travel. The partnership has been so successful it now includes similar centers in 13 other states.

Together, Smith and Baker send 450 Canadians to treatment every year. According to their estimates, meanwhile, at least 1 million Canadians currently linger on waiting lists for essential medical treatments.

Canadian patients persuasively spoke of horrors they were subjected to under Canada’s socialist system. All clearly expressed their belief that Canada’s system is great most of the time. It’s just when you’re really sick that things start to fall apart.

Ultimately, both the U.S. and Canada suffer from excessive costs and discouraging access rates. We should take the lead of a handful of innovative medical entrepreneurs, who together are improving health care one patient — and, if all goes as planned, two nations — at a time.

This article originally appeared in The Denver Post, October 8th, 2009.