by G. Keith Smith, M.D.

Alvin Lowi, writing in 2008, made a compelling case that Prohibition was never repealed, but rather, that Al Capone and Uncle Sam merely traded places.  Without a doubt, brutal consequences await anyone who attempts to skirt the taxes and tribute demanded by the D.C. mob with regard to the sale and distribution of alcohol-containing beverages.  This tight control of commerce, from which “juice” is extracted, pervades the medical industry, as well, as the D.C. syndicate currently controls half the sale and distribution of medical commerce in this country.  Viewed in this way, it is clear that the “Medicare for All” (Prohibition of Choice) initiative represents a shameless attempt to completely control the funds flowing through this industry, a move that would make even Mr. Capone blush.

Think this is too harsh?  That Prohibition made mobsters rich differs in what way from how Obamacare made D.C.’s medical cronies rich?  The sad truth is that each and every time a new law is passed and the regulators appear (almost always connected with the industry ostensibly regulated), another chunk of commerce passes through the inefficient and corrupt toll booth of the D.C. “outfit.” In addition, industry consolidation predictably materializes with each new law, so fewer and richer “captains” will remain to kiss Uncle Sam’s ring.

In the same way that many mob-related terms disguise their true meaning (made, juice, family), the titles chosen for many laws serve as decoys for their intended effect.  Just as there was nothing Affordable or related to “care” in the Affordable Care Act, the deceit attached to the phrase “Medicare for All” belies the fact that if enacted, the purchase or sale of medical services outside of this systemwould necessarily be unlawful, or this gangland attempt to coopt the industry would get nowhere. 

And while the purchase of medical services outside of this new system would be prohibited for you and me, rest assured that our “representatives” in D.C. would exempt themselves from this restriction, just as they did with Obamacare and just as they did during Prohibition.  President Wilson was given a special exemption for his private wine cellar, FDR was known to keep “stocks of gin, rum, and scotch in a closet of his New York home,” and not to be outdone, Congress had its own bootlegger.  Remaining true to this tradition and for our own good, the D.C. protection racket managed to remain immune from Social Security taxes until 1984 and continues to have special access to benefits apart from Medicare. Rest assured, “Medicare for All” rationing would not apply to them. 

Two of Medicare’s flaws deserve special attention, both highlighting the syndicate-like mentality that pervaded Prohibition days.  First, in 1992, Uncle Sam’s “outfit” achieved complete control of those doing business with them, when during a Republican administration, the price-dictating Resource Based Relative Value Scale (RBRVS) was inflicted on the industry. It is important to understand thattrue prices emerge from competitive activity, fluctuating around a market-clearing price.  Prices are, after all, signals that connote the presence of surpluses or shortages and serve the purpose of minimizing resource misallocation.  Top-down prices, like RBRVS prices are always wrong.  They are either too high or too low with predictable results.  If doctors or hospitals are paid a very lucrative amount for one service and a paltry amount for another, surpluses and shortages of care will predictably materialize.  This “soft rationing” is a powerful budget-balancing tool for government programs like Medicare, which has recently forecast its own bankruptcy by 2026. 

Second, the payroll taxes of those currently working are the primary source of revenue benefiting those receiving Medicare’s benefits, most of whom are no longer working.  Charles Ponzi, just like Bernie Madoff, utilized this ploy to lure individuals into their designs, benefitting early investors with funds from newer investors.  These schemes, once discovered, disintegrate without the muscle of the government outfit to force future “contributions.” 

Finally, for those who believe that the D.C. gang has had our best interests in mind, remember that in an effort to enforce Prohibition, the government deliberately poisoned spirits they knew were destined for consumption, resulting in the deaths of thousands of individuals and the blinding of many more. “The welfare of the masses is always the alibi of tyrants,” Albert Camus’ famous quote, should embolden our skepticism for those who would inflict “Medicare for All” on the rest of us, a scheme that will undoubtedly prove more deadly and tragic than Prohibition at its peak.

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Anesthesiologist Dr. G. Keith Smith serves as the medical director, CEO and managing partner of a “free market” outpatient surgery center in Oklahoma City, while also maintaining an active private practice.

Dr. G. Keith Smith is the co-founder of the Surgery Center of Oklahoma, one of the few medical facilities in America that openly posts the prices of its surgeries on its website. The fee-for-service medical facility is devoted to delivering top-rate care at a fraction of what conventional hospitals charge.

When Dr. G. Keith Smith launched the first website displaying all-inclusive pricing for various surgical procedures in 2009 it attracted national and even international attention for him and the Oklahoma medical treatment facility, which is owned and operated by around forty of the top physicians and surgeons in central Oklahoma.

Since then, many Canadians and uninsured Americans have taken full advantage of the low and transparent pricing available at the surgical treatment center.

The operation of this free market medical practice, arguably the only one of its kind in the U.S., has also garnered the endorsement of policymakers and legislators across the nation.

The Surgery Center of Oklahoma’s consumer-driven model could well become increasingly more common as Americans look for alternatives to the traditional health care market in the face of higher costs and reduced access to doctors and hospitals under the Affordable Care Act.

Dr. Keith Smith, co-founder of the Surgery Center of Oklahoma, explained to Bill O’Reilly (The O’Reilly Factor) how patients across North America have grown increasingly tired of waiting in line for prohibitively expensive medical treatment and will naturally gravitate towards lower-cost, higher-quality medical care available from physicians and facilities outside of ObamaCare.

Self-funded insurance plans are already taking advantage of Dr. Keith Smith’s medical services pricing model in greater numbers, resulting in significant savings to their employee health plans.

Dr. Keith Smith believes that the healthcare system is perversely designed to keep Americans paying higher and higher prices while subsidizing huge corporate-controlled hospitals with tax dollars obtained through their fictional not-for-profit status.

Dr. Keith Smith took the opportunity to discuss with John Stossel just how these “non-profit” hospitals and insurance companies drive up the cost of care by practicing dishonesty in pricing.

Dr. G. Keith Smith hopes that as many medical treatment facilities as possible adopt a similar transparent pricing model, a move he believes will lower healthcare costs for all and improve quality of patient care.

To encourage widespread adoption of his proven methods amongst the medical profession, Dr. G. Keith Smith co-founded the Free Market Medical Association so as to revolutionize managed medical care through treatment cost transparency.