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Welcome to "This is Health, Wealth, and the Pursuit of Happiness" your source for insightful discussions with economist and author, Dr. Murray Sabrin. Join us as we challenge convention, expand minds, and pursue truth.
Murray Sabrin (00:02.112)
Welcome to Health, Wealth, and the Pursuit of Happiness. I'm your host, Murray Sabrin, B A, A, Ph D, There's No BS My Background, Never Has Been and Never Will Be. On this Podcast, we explore the ideas, the people, and the principles that shape healthier lives, greater prosperity, and human flourishing. In each episode, we'll challenge the conventional wisdom on healthcare, economics, politics, and personal freedom so you can think independently, make better decisions, and pursue your happiness.
Thank you for joining us today. And it gives me great pleasure to introduce our guest today, Dr. Keith Smith, who's a board certified anesthesiologist in private practice since 1990. In 1997, he co-founded the Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, owned by over 40 of the top physicians and surgeons in central Oklahoma. Dr. Smith serves as the medical director, CEO, and managing partner while maintaining an active anesthesia practice.
In 2009, the website gave patients or prospective patients full transparency on what it would cost them to be a patient and get their surgery at the Surgery Center of Oklahoma. Dr. Smith has appeared in Congress, testifying in both the House and the Senate. He's been on national media programs, been featured in national media outlets, and his reputation is known throughout the nation and even internationally.
So it gives me great pleasure to welcome Doctor Smith to our podcast. Keith, it's great to see you again.
Keith Smith (01:34.647)
Good to see you, Murray. Thanks for having me.
Murray Sabrin (01:36.994)
Well, we have a lot to unpack here because medicine, medical care, the cost of medical care has gone through the roof. It it consumes nearly twenty percent of the G D P. So let me ask on a personal level, what b what made you decide to become a physician?
Keith Smith (01:53.517)
Well, I was raised in a in a home where the golden rule really meant something. mutually beneficial mutually beneficial exchange was just part of our daily life. And I was taught not to be part of an exchange that was not mutually beneficial, even if I was the beneficiary. as a physician, I was I envisioned myself as being part of a mutually beneficial exchange with every patient.
that I encountered. And that was a big part of of why I went into medicine. That's a really beneficial exchange if if both parties are there voluntarily. And it just fit it fit my upbringing. And it and it's interesting, it's challenging, it's gratifying. so I that that's really why why I pursued medicine.
Murray Sabrin (02:44.685)
Terrific. And so the next logical question is you were in private practice and then you and your partner co-founded the Surgery Center of Oklahoma. What was the process of founding the surgery center?
Keith Smith (02:59.265)
Well, I I started my practice in nineteen ninety and it wasn't long before I realized I was part of exchanges and enabling exchanges that were not mutually beneficial. And I didn't really want to enable these monster hospitals where I worked to bankrupt and financially destroy patients to whom I was administering an anesthetic. The only solution really was just to walk away. and so
Steve Lontier, like minded anesthesiologist, he and I walked away from what anybody would characterize as very successful anesthesia practices. And we walked out in nineteen ninety seven. We we just walked away and decided the only way we'll be able to provide care that we can not just medically control, but also financially control for the patient's sake. And we did that in nineteen ninety seven.
Murray Sabrin (03:52.205)
Mm.
Murray Sabrin (03:56.654)
Was that a challenge, leaving your job at the hospital and getting the capital to create the f surgery center?
Keith Smith (04:04.491)
Yeah, it was. It was it was a five year effort. Yeah, I actually started my attempts in nineteen ninety two to walk away. and it took five years. It was a it was an incredible challenge. it I don't tell the story very often, but at the last minute, all of the financial guarantees that the twelve surgeons that were going to co fo found it with us
All of those guarantees were declared ineligible and not valid by the bank we were working with. So so Steve Lontier and I personally borrowed all of the money that we needed to start the facility. It was everything we had and everything we could borrow. So just the two of us actually opened it because the bank wouldn't recognize the way the guarantees were written. we were so successful that the bank
Murray Sabrin (04:54.773)
Mm.
Keith Smith (04:59.217)
within just about three or four months attached to our accounts receivable as the collateral and was happy to do it because that that was that was a number that that that they could use to collateralize the entire the entire outfit. We didn't build a facility right off we actually assumed the lease and bought the operations of one that was already that was already operational that was failing.
Murray Sabrin (05:26.081)
No.
Keith Smith (05:26.303)
And so all we really had to do was buy the operations and assume the lease. We didn't have to come up with the capital to build one.
Murray Sabrin (05:33.389)
Terrific. That that is a great story because sometimes when someone is in distress and someone comes along with a better idea or better management, you can move in and not risk so much capital to do so. So congratulations on that effort. So take us through the process of a patient becoming eligible for surgery at the center.
Keith Smith (05:57.133)
So from the very beginning we we saw ourselves as offering true value and and we knew we would appeal primarily to patients that had sticker shock, whether they had a high deductible, they had insurance that had denied them, whether they were uninsured, member of a cost sharing ministry, member of a self funded health plan.
Murray Sabrin (06:25.889)
Hm.
Keith Smith (06:26.205)
with their employer acting acting as their proxy. So we we knew we we really could appeal to buyers that had sticker shock. We also thought very mistakenly that we would appeal to insurance companies because I mean logically you would think they they would like cheaper and better and we had every reason to believe we were going to be just that. what we found out is we did appeal
to patients that had sticker shock but did not appeal to the insurance companies. And that was not clear until years later after I launched the website what about why they why they hated us.
Murray Sabrin (07:07.383)
So when you opened up your doors in nineteen ninety-seven, how long did it take for you to get patients? Because after all, do you ad w we were able to advertise? the internet was just getting started in the mid-90s. And so was it word of mouth of doctors in your area? Was it word of mouth of doctors in the surrounding states? Take us through that process.
Keith Smith (07:27.533)
So when we opened, there were 12 surgeons on our staff. right now there are 147 surgeons on the staff. But when we opened, there were only 12 and they would bring us their patients. they would bring us patients that actually had insurance, and we would file a claim as an out-of-network participant.
So none of the insurance companies would let us in the networks, but we would file claims for them out of network. We we made we had a mission. Our mission was to never accept a diamond money from the government. And our other mission was to ensure patients knew what they were going to pay us prior to arrival. What we discovered is the amount of money we were asking for patients to pay was less.
than they're in network deductible at a big hospital. So that's really how I sharpened my teeth on this concept of creating all inclusive case rate surgery prices, was quoting those prices to patients that actually had insurance. because it we were financially a better deal for them if they didn't use their insurance. So that is where our initial patients came from.
Murray Sabrin (08:44.973)
Hm.
Keith Smith (08:49.005)
uninsured patients eventually found us and the word spread word of mouth that if you don't have insurance, you know, this surgery center of Oklahoma will make you a smoking deal.
Murray Sabrin (09:01.293)
So if a patient does have insurance, do you still are still are they still eligible to be a a patient at the surgery center?
Keith Smith (09:08.843)
They are, but they pay us and then they get to go deal with Blue United Cygna Aetna and see why I won't. but we would we do not file out of network claims anymore. I am finished with that. All that does is just create headaches for everyone. now our most rapidly growing demographic right now are patients that actually have insurance but have been deny delayed or denied.
Murray Sabrin (09:16.055)
Interesting.
Murray Sabrin (09:34.786)
Interesting. Interesting. one of the I think the first time I heard about you, I I I don't know the exact, but I think it was when I interviewed a direct primary care doctor who you well well know. She interviewed you for medical economics, Dr. Rebecca Bernard in Fort Myers, Florida. And she told me about a patient she had, and she mentions it in the interview. walk us through that patient, that patient that I think she said needed a life saving surgery and sh and
Keith Smith (09:51.413)
yeah.
Murray Sabrin (10:04.161)
And the patient came to you for treatment?
Keith Smith (10:07.617)
think this is the patient that had a gigantic thyroid gland that needed to be removed and also required some coordination in Florida for r some radiation therapy or nuclear medicine therapy. So we we coordinated this case. I traveled to Oklahoma like so many people from out of state. actually forty percent of our patients are not
do not live in Oklahoma. they travel to us. the if they're part of an employer plan, the employer waives all of their out of pocket, pays their travel costs for them and a companion. because the prices in our facility are frankly one eighth to one tenth of what the so called not for profit hospitals charge for the very same service. So yeah, we got that we got that patient's care coordinated and sent them right back to Florida and
Murray Sabrin (10:37.997)
Mm.
Keith Smith (11:05.631)
It was it was seamless.
Murray Sabrin (11:07.831)
So right now, do you ha do you advertise your services in various v venues? Or how how do you get patients without referrals from doctors?
Keith Smith (11:17.953)
So everything changed in 2009 when I launched the website with prices. Patients then were attracted to the surgery center of Oklahoma, not necessarily to an individual surgeon. So patients that came to Surgery Center of Oklahoma seeking help for whatever their s condition was that required surgery, I then assigned those patients to the surgeons who who I thought were appropriate for the job. So
Yeah, when I launched the website, we were fortunate to receive some national media attention very early on. and I wrote a bunch of blogs and did a bunch of video blogs and just tried to speak to anyone who would listen. and was given a stage really by by a lot of people who I'll I'll always be thankful for. and then, you know, started to harness the power of social media.
So the the Surgery Center of Oklahoma is on all of the social media now. and a lot of people find us find us that way.
Murray Sabrin (12:25.453)
Terrific. what are some of the common surgeries you do at the center?
Keith Smith (12:30.123)
I think I looked at this just the other day. I think the most common procedure we do right now is an inguinal hernia repair, followed very closely by gallbladder removal. we also do a lot of orthopedics, a lot of earnose and throat. three of the four anesthesiologists at our facility, me included, are fellowship trained in pediatric anesthesia. So we do a lot of a lot of pediatric surgery, and just just about every specialty that you can you can think of.
Murray Sabrin (12:36.557)
Mm.
Keith Smith (13:00.225)
But I I would say that general surgery, ear nose and throat, goncology, urology, orthopedics, we do we do all of that.
Murray Sabrin (13:09.763)
Any c cardiac surgery?
Keith Smith (13:12.821)
No, we're an outpatient surgery center limited really to a twenty-three hour stay. we did inspire, I would argue we inspired the construction of a cardiac hospital. and and I send everything to them because they're great.
Murray Sabrin (13:31.405)
So so you have a cardiac surgery center, not you personally, but some modeled after you in Oklahoma. So how did that come about?
Keith Smith (13:43.969)
Well, we were not the first to be a physician owned facility in Oklahoma by any stretch, but our model really was unique where we we made sure patients knew how much they were gonna pay us before they arrived and we never surprised them with a different amount. And if I was wrong, I gave the patient money back.
And if I was wrong on the other side, we ate it. We'd never ask for more money than what we told them they would need to bring when they arrived. So this model was radical. it was it was inspiring to a lot of other physicians that I did not work with. but there's a heart hospital here in Oklahoma that that sprang up and was inspired by hopefully, you know, that being able to copy our model. There was a spine hospital.
that's an outgrowth, I think, of our model. There are lots of surgery centers now that are open that I would argue have been inspired have been inspired by our model. And it it's really gratifying to see there's an outpatient surgery center that only does cardiac procedures, catheterization, stent placements, pacemakers. there's an outpatient surgery center in Oklahoma here in Oklahoma City that was inspired by us that only does cardiac stuff.
So yeah, it's it's it's really gratifying to watch.
Murray Sabrin (15:05.878)
Now
Murray Sabrin (15:09.771)
Now, something like that is not inexpensive relative to the other surgeries that are performed at your center. So does a patient have insurance that does it that gets a cardiac surgery?
Keith Smith (15:21.111)
So the the patients that we draw on, just like this cardiac center, are patients that have sticker shock themselves or their proxy buyer has sticker shock, like the somebody that runs a self-funded health plan or whoever administers a self-funded health plan or a cost-sharing ministry or a cost-sharing group. So if they see, for instance, that they can buy
Murray Sabrin (15:34.135)
Mm-hmm.
Keith Smith (15:49.833)
A heart catheterization with the placement of two stents for eleven thousand dollars, they're gonna buy that all day long. instead of pay sixty or seventy thousand at a big hospital for the same thing that's not done as well, I would argue. We perform very complicated surgeries at Surgery Center of Oklahoma. We just don't do any anything that's cardiac related.
Partly because I can't compete with this other outfit on quality. I there's no way. I just send everything to them. and I could tell you more about how we facilitate that, but you know, we do total joint replacements, we do hips and knees and shoulders and ankles. we do cochlear implants, hysterectomies, big big spine surgeries. We do a lot of that stuff at our facility. But if if somebody steps into the marketplace and they're better than me, I just support
Rather than try to compete with them.
Murray Sabrin (16:47.533)
Sure. How are your prices determined? Because one of the s one of the typical critiques of medicine, especially for people on the left, is that medicine is too important to the for the marketplace that we need wise government dis decision makers to to determine prices. So how are your prices determined and what's your critique of of the of the critique of free market pricing?
Keith Smith (17:11.969)
Well, keep in mind as I answer this, there are a lot of people in the industry with a lot more letters after their name than mine that will tell you this is too complicated and they can't do it. So I want you to hear my answer through that lens. So the way I do it is I call a surgeon and I ask them how much do you want? And they give me an answer and it's usually too low, frankly.
as an anesthesiologist, I basically bill for my time. That's not entirely true, but it's mostly true. So I have to decide what 30 minutes of my time is worth and then let the market judge me right or wrong. On the surgery center side, I treat the facility on a time and materials basis just like a general contractor. I know how long every one of these surgeries is gonna take with a l very little margin.
and I know what the cost of supplies is to perform all of these surgeries. So those are the three components. And you add those up. It's not even algebra, it's arithmetic. And that's my price. And that's what the patient pays. And then after the procedure, particularly a new procedure we've never done before, I look back and how did I do? And if I didn't do well, high or low, I revise that number. So that's how
That's how I do this. We don't try to make a make a bunch of money at the surgery center. The surgery center is not a profit generator. It's a tool of our practice. It is profitable, but not very profitable. I've always thought the people who do the work should be paid very well. And the tools should not be a source of profit for in in that we consider the surgery center of Oklahoma just a tool.
Murray Sabrin (19:04.109)
So when a patient comes, you mentioned twenty three hours, does the typical patient sten spend less than one day at the surgery center, or do some patients have to spend more than a day at the surgery center or a local hospital a local hotel?
Keith Smith (19:19.169)
Yeah, no one says more than overnight at our facility. We I'm still pretty old school. We like to keep patients that have knee replacements or hip replacements. I like to keep them overnight, just to watch them overnight, make sure they're walking okay. And then let's say they've traveled to see us from Alaska or Canada. We see a lot of Canadians. we'll keep them overnight for a big procedure like that. And then if if they need to stay in town longer.
Murray Sabrin (19:39.117)
Mm.
Keith Smith (19:48.063)
If that's medically appropriate, yeah, they go to a hotel. If it's a near knee or hip replacement, we send home health nurses out there twice a day for five days just to make sure they're doing okay before before they travel home.
Murray Sabrin (20:02.647)
So the next logical thing would be you mentioned already the prices that you charge at the surgery center is a fraction of what a hospital would charge an insurance company or Medicare and or Medicaid. So from that perspective, how many surgery center of Oklahoma's are there in the United States? Are there a dozen? Are there a hundred? Are there a thousand? Wha what's your estimate of how many there are that that follow your model?
Keith Smith (20:29.239)
So there are about a dozen that copy my model almost exactly. there's one in Indianapolis called Wellbridge. There's one in Moscow, Idaho called Veritas. There's one in Austin, Texas, Texas Free Market. there's a couple in Wisconsin, Solstice and Renovo. There's one in Littleton, Colorado, that honored me by naming it after me. It's called Smith, it's called Smith Direct Surgical Care.
And I have no financial interest in it whatsoever. but I but I help them like I've helped all these others launch. Those are the kind of carbon copy copycats. There are a lot of others though that will quote prices over the phone. They won't list them on a website, but they'll quote prices over the phone. And they won't list prices because they're they're still dealing with insurance carriers. And I don't deal with insurance carriers. So
Murray Sabrin (21:24.181)
Mm.
Keith Smith (21:26.453)
There is some fear that posting all inclusive prices online might represent a problem with the contract language in a carrier contract. I don't have any such constraints, but many do. Those that will quote prices over the phone, I would argue number it number in the hundreds. so this this has become really a nationwide movement because
Keep in mind in 2009 when I launched this website, I had a tinfoil hat placed on my head. It was crazy. we were the first ones to do it, and it was completely it was thought of as completely insane to say, here is what I do and here's what I charge for it. I mean every other industry has to endure that market pressure, and I thought we should too. But the narrative has changed. Now, if you won't answer the question.
How much are you going to charge me for filling the blank? Whatever the procedure is, appendectomy, you know, straightening my nose, gallbladder, knee arthroscopy, total knee. If you won't answer that question, then you receive scrutiny. So those that won't answer the question, number so large now, and they've lost so much business to those of us who will place a price on it.
Murray Sabrin (22:37.645)
Mm.
Keith Smith (22:49.623)
that they have started quoting prices over the phone. And I think that number is in the hundreds and probably in the thousands.
Murray Sabrin (22:56.525)
Interesting. Do you do you get any Medicare patients? Because you would think that Medicare patients with pr Medicare or Medicare Advantage plus supplemental, they would they would not be seeking your services. Is that the case?
Keith Smith (23:13.559)
For the most part, medic anybody that's a Medicare beneficiary won't come see us because they don't have sticker shock. Where they get where they get into trouble is when Medicare denies them what they need. and that's when they'll come see us. I have to be careful though, because the only surgeons that can work on patient Medicare patients outside of Medicare are the surgeons that have opted out of Medicare. And I have four
Murray Sabrin (23:20.109)
Mm.
Keith Smith (23:43.327)
surgeons that have opted out. Now one exception to that, let's say a Medicare patient has had a cochlear implant placed so that they can hear. Well Medicare won't pay for the other side. They won't pay for the, you know, if they paid for the left, they won't pay for the right. So med some Medicare patients will come see us because they want a second cochlear implant on the other side.
Murray Sabrin (24:12.557)
Mm.
Keith Smith (24:13.097)
and so Medicare just doesn't even recognize that any more than they'd recognize a breast augmentation or, you know, some plastic surge facelift. So in that in that situation I can deal with Medicare patients directly.
Murray Sabrin (24:28.555)
Interesting. Interesting. What have been some of the challeng the most challenging surgeries you've had at the center?
Keith Smith (24:36.185)
I think the most challenging surgery we do in general is pediatric surgery. we also do some fairly big general surgeries like hiatal hertea surgery, joint replacements. Those are those are big challenging cases. but you know we'll we'll anesthetize a six week old you know for for surgery. We have we have a
six week old coming up for a for an ear surgery. we did a we did a bilateral bose side cochlear implant on a ten month old just a few months ago. So those are those are big surgeries and those are little bitty babies. And, you know, that's not that's not the stuff that, you know, a lot of surgery centers that, you know, were just involved at placing a strip mall, you know, doing a lot of hammer toes and bunions. It that's
Murray Sabrin (25:32.855)
Sure.
Keith Smith (25:33.606)
We are multi specialty in doing complex surgeries.
Murray Sabrin (25:37.485)
Interesting. Let's get to the heart of the theme of this podcast about health care, about prosperity and the pursuit of happiness. And we talked a little bit about insurance. from your perspective, are the American people overinsured?
Keith Smith (25:54.789)
I would say yes and no, until until an American realizes that there is another way, there is another path that they can and should patronize. If they don't realize that, they need all the insurance that they can get. Because if without insurance what one of these big not for profit hospital systems is going to do to someone is going is they're going to financially destroy them.
Once once somebody in the United States realizes that they have options, that there are cash priced options that they can find and use, then they may actually feel like they can bear that risk more themselves and not be so heavily insured. the cost sharing ministries have done a great job trying to educate people. Crowd health is a big one.
Christian Healthcare Ministries is a big one. Liberty Share, Samaritan, Zion, Solidarity Share. There's a whole bunch of them. they've done a pretty good job helping individuals realize that you can buy a colonoscopy. It's eleven hundred dollars here in Oklahoma City. You know, you can buy a knee replacement. That's, you know, $17,579 at my place. And that's a lot of money.
But that's that's less than a year's premiums paid to Blue United Signor Etna. you can buy open heart surgery for about thirty four thousand here in Oklahoma City at the facility that I would go to if it were me. That's two years premiums. So yeah, it's a lot of money, but it's two years premiums paid to Blue Cross or one of those folks. So
Murray Sabrin (27:44.364)
And and these and and and just let me interject for for our audience who who are not familiar with cost sharing, this is not insurance. can you take us quickly through what a cost sharing outfit would do for people who don't want the typical medical insurance that the big insurance companies offer?
Keith Smith (28:02.925)
So the way the cost shares work from the patient's side kind of looks like insurance. through the patient's lens, it kind of looks like insurance, but it's not. Essentially, cost shares are where members pay other members' bills. and so the the the problem the the the thing that people don't like about it a lot of times is that the patient has to be a responsible buyer.
Murray Sabrin (28:30.509)
Mm.
Keith Smith (28:30.529)
I mean they have to be motivated. They have because they are going to pay for the oil changes. Whereas insurance wants to pay for the doctor's visit. that the cost shares are not going to pay for the doctor's visit. They're not going to pay for the little stuff. It is there it is there for the big stuff.
it's it is an an extension of what people used to call mutual aid societies. it's the same it is the same concept where, you know, members of the Elks Lodge take care of each other and they don't hire somebody in a five thousand dollar suit, you know, to administer some giant amount of money. you know, so it it's essentially mutual aid societies writ large.
Murray Sabrin (28:58.571)
Right, right.
Murray Sabrin (29:05.58)
Right.
Murray Sabrin (29:18.559)
And how do the the annual costs compare to a typical policy for a family of four?
Keith Smith (29:25.709)
that's a great question. So if you're an individual and you belong to a cost sharing ministry, you're gonna pay about three hundred bucks a month, maybe two hundred and fifty dollars a month. Now you're gonna have some exposure. You're you know, you're gonna probably have to bank two or three or four thousand dollars for any kind of stuff that comes along. But keep in mind there are surgeries. Most of the surgeries at the surgery center of Oklahoma you can buy. This is surgery.
for under five thousand. So if somebody will just bank a little bit of money, then they can pay two or three hundred dollars a month and then the other members will share expenses that happen to come along. Unfortunately they do, and then and then everybody kind of helps each other.
Murray Sabrin (30:13.751)
Yeah, the Mutual Aid Society has been mutual aid societies have been around for a long, long time. there's a wonderful book by David Bieto about that. And it's just a wonderful narrative of how these things evolved over time. And it's I guess the way to explain it to the average person, it's it's the ra barn raising that families did out on the prairie in Oklahoma the centri decades ago in order to help their neighbors get a farm and have a
placed for their crops and what have you. So we just have a few minutes left. so from your perspective, what would a free market medicine system look like in the United States given h how much we're spending today on hospitals, on on insurance for
Murray Sabrin (31:14.903)
Sorry about that, Keith. s so how how much would how what would what would a free market medicine system look like? in other words, you would have people pay out of pocket for doctor's visits, they would bank some of that money for maybe some more visits, and then if they needed some surgery, the mutual aid society or the cost sharing would provide for the cost of going to the surgery center of Oklahoma or something locally. Is is that the your inv vision for what a free market medicine society would look like?
Keith Smith (31:16.513)
Okay.
Keith Smith (31:44.171)
think so. in the first place it wouldn't be a system. I had a long conversation with Jeff Dist one time about this. He says, what we don't have a shoe system. You know, we don't have a clothes system. Why do we call it a system? So in the first place, I don't know what it would look like. I think that there would be a whole lot of different competitive alternatives from which patients could choose and and choose the one that suited them the best.
Murray Sabrin (31:48.524)
Right.
Keith Smith (32:13.593)
from a bird's eye view, it would be exactly what you described though. It would be people pay for the little stuff and then they gather together and lock arms and cooperate as human beings normally do and help each other.
Murray Sabrin (32:27.903)
And you're the founder of the Free Market Medical Association. Just quickly tell us what that's all about.
Keith Smith (32:33.495)
So I co-founded the Free Market Medical Association with Jay Kempton, a member of the industry who administers self-funded health plans for a lot of grateful employers. and the idea was to bring market discipline to this industry in an educational way. it is very Austrian. We are we are unapologetically Austrian in our view of economics.
And we it's it's been a little bit of a re education camp for a lot of physicians that are members and and other people in the industry to learn really what is the true definition of value and how do you how do you interact, how do buyers and sellers interact in a mutually beneficial way? It's a large organization now. we are transitioning to a not for profit organization because we've had some
Big big money come at us wanting to help throw gasoline on this movement and these ideas. We originally set up as a for profit so the IRS couldn't mess with us, but we're gonna transition to a nonfor profit just to accommodate large donors that want to help us out. It's in thirty seven states. it's website if you don't mind me mentioning fmma.org. Murray, you've been, you've spoken.
Murray Sabrin (33:55.351)
Sure.
Keith Smith (33:59.037)
at at the meeting. love to see you again.
Murray Sabrin (34:02.635)
I'd love to be there again because growing up in New York City in the nineteen fifties, Medica med medical care was really simple. You my parents, you take you to the doctor, they pay five dollars for the office visit, and you'd go to the local pharmacy and fill out a prescription, no copays, no deductibles. My father had a major operation in nineteen sixty one at the Lennox Hell Hospital in Manhattan. Blue Cross Blue Shield took care of it. this is before Medicare and Medicaid.
It was a seamless process. I don't recall any financial difficulty facing the family. And that to me is the model that I grew up with. And I said, why can't we have that model today? And I think to I'm gonna use the word, medical care has been corrupted by the government and the insurance companies. And I wish people like you who exemplify a term that you don't really hear about in medicine, medical entrepreneurship.
Making sure that you deliver of something of value to your customers. In this case, it's it's the patience. And everyone should learn more about it. What's the website where people can find out about how your services are offered, the prices that you have, and hopefully maybe and hopefully they won't need your services, but if they do need your services, they know there's a place they can go to, right in the middle of the country in Oklahoma City. So what's that website, Keith?
Keith Smith (35:23.169)
Well, one website is Surgery Center OK dot com. that's a surgery center's website. Another is the Free Market Medical Association, F MMA dot org. And then another website people should check out if they need complicated inpatient care is Atlas Billing Company dot com. That's where you can find out if you have colon cancer or a brain tumor, how much that should cost. Those are
Those are case rates I've cobbled together over the years. they're all all purchasable and buyable by individuals.
Murray Sabrin (36:01.111)
Keith, this has been terrific. you've given us a lot of information for people to embrace and improve their health care in the United States because we are spending so much money on health care and it seems the American people are getting sicker and sicker given the chronic illnesses that people are facing in this country. So I want to thank you for being on the Health, Wealth and Pursuit of Happiness podcast. And we look forward to having you again talk about the free market free market medical
association because we need more freedom in America. That's going to solve a lot of the problems that we're facing here in the country. So thank you for being here. say hello to all your wonderful physicians and surgeons in Oklahoma. And if you can hold on for a minute, let me close up and then we'll get to we'll do a chat a little bit afterwards. So thanks for listening to Health, Wealth and the Pursuit of Happiness. I'm Murray Saber and until next time. Keep questioning conventional wisdom, keep pursuing truth, and keep striving for a healthier
Freer and more prosperous life and visit mafiausa dot com to join the financial independence movement. if it's going to be a free America, it's up to us to make that happen. So until next week when we'll have we'll go back to investment and we'll have Michael Oliver talk about his approach to helping people get more prosperous in America. So thank you for listening and we'll see you next week.