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2013
Awards
tals, big insurance, big "You can't operate a business the way you
pharma and — most
want to if you accept federal money.
There are too many strings attached."
of all — the federal
— Keith Smith, MD
government.
They don't underestimate the opponent.
("There are a lot of
vested interests and
special interests that
are going to throw real
money down to protect their turf," says Dr. Smith.) But they remain defiantly confident
that their secret weapon will ultimately prevail. "It ought to be daunting for them," says Dr. Smith. "The truth is what it is."
The truth, they say, is that what's responsible for runaway costs is
the lack of real and honest competition — thanks largely to people
who sing the praises of the free market while simultaneously making
backroom deals to undermine, if not completely eviscerate, competition.
"There's very little free market in medicine," says Dr. Smith. "What's
going on in the United States is not a failure of the free market, it's an
absence of the free market, except in LASIK and plastics. The free
market is alive and well [in those] and prices have plummeted and
quality is off the charts. Just like every other industry in this country
— cell phones, computers, you name it. If there's real competition, the
producers have to work very, very hard to demonstrate value."
Having concluded that Washington was the hub of everything that was
wrong with health care in the United States, the first step for Dr. Smith
was to dissociate himself to the greatest degree possible. He began to do
just that several years before he opened the surgical center, after seeing
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013
