Department of Motor Vehicles: a National Model for Healthcare

By G. Keith Smith, M.D.,

As ObamaCare becomes ever more unpopular, the single payer idea keeps coming up. So let’s consider what a single-payer system would look like. There are so many places to look it’s a little confusing. Here’s a partial list.

Canada tends to come up first, and I think about it a lot. That’s because lots of Canadians come to our facility in Oklahoma for their care. Do I really need to say anything else? These are people who have been told to wait for years before they can see a specialist because there are budget “caps.” When the money is gone, the doctor’s office is closed. Surgeons are allowed only so much time in the operating room in a month. When they have used up their time, they can do no more surgery. Rather than have the market determine the allocation of resources, a Canadian bureaucrat creates a budget and that’s that. Presto! The “right” to healthcare is defined. It might not feel too much like a right, however, to those who have to travel to the U.S. for timely surgery, or for those who die waiting in line for care.

Then there’s Britain. The Brits harbor such nationalistic pride in their healthcare system that they celebrated it in the opening ceremonies for the London Olympics. It is based on the same faulty economic premise as the Canadian system. The Brits not only euthanize their sick citizens to free up scarce hospital beds (do you wonder how this shortage of beds came about?), but they are proud of this and have even given this highway to the cemetery a fancy name: the Liverpool Care Pathway. British patients that become extremely ill have a better chance of survival at home, surrounded by family and friends, as no one stands a chance once on the LCP. Recovery from severe illness can occur without the help of modern medicine, but recovery of the very sick isn’t likely when the hospital staff is actively murdering them.

But there is no need to go outside of the U.S. to see the wonders of socialism in medicine. The VA hospitals and the Indian hospitals provide examples of efficiency brought to us in medicine from government bureaucrats.

Our local paper’s lead article recently informed us that the Department of Public Safety (DPS) was closing the office administering driver’s tests for the day to train their employees. Zeke Campfield of The Oklahoman writes that the “operator of a local Chick-fil-A restaurant will teach examiners how to be patient and courteous.”

What would happen to an employee at Chick-fil-A that was not patient with and courteous to customers? What would patrons of Chick-fil-A do if they were not treated in a timely manner and with respect? What would happen to Chick-fil-A if this treatment of customers were widespread?

Campfield’s article also talks about a mother getting in line outside the DPS testing center at 4:15 A.M., only to be turned away at the end of the day because there were simply not enough examiners to get to her son. Three mornings in a row. The spokesman for the DPS muttered something about budget cuts, so I’m guessing we’ll see government’s usual response, that of throwing even more money at failure.

Try to imagine the DPS in charge of your medical care. Rude and inefficient staff. No competitive fears. Hospitals working together to institutionalize mediocrity so no one stands out as better, eliminating troublesome comparisons. Long waiting lines. Always blaming the lack of funding or budget caps.

The efficiencies and quality of the private sector cannot be superimposed on government agencies for one simple reason: without competitors, government doesn’t have to care. Ever. Our state government wants to introduce private sector ideas into a failed government organization. Ironic, isn’t it, that health care bureaucrats are increasingly embracing the business plan of the DPS, even as the DPS is looking for private-sector answers? At least the DPS hasn’t started euthanizing applicants waiting in line to free up examination spots.


G. Keith Smith, MD is 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, Oklahoma, owned by 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, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility, national and even international attention. Many Canadians and uninsured Americans have been treated at his facility, taking advantage of the low and transparent pricing available.

Operation of this free market medical practice, arguably the only one of its kind in the U.S., has gained the endorsement of policymakers and legislators nationally. More and more self-funded insurance plans are taking advantage of Dr. Smith’s pricing model, resulting in significant savings to their employee health plans. His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs for all and improve quality of care.

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