Free Market Health Care: Breaking the Status Quo

Recently, I was lucky enough to represent UMA Health at a conference hosted by the Free Market Medical Association (FMMA) in Oklahoma City. Over the course of two days, physicians from all over the United States gathered to network and learn more about the trends in the health insurance industry and, more specifically, how so many have begun shifting their businesses to a direct pay model, bypassing insurance entirely. Speakers included Jay Kempton, founder of the Kempton Group, and Keith Smith, founder of the Surgery Center of Oklahoma — Jay and Keith also happen to be the pioneers behind the FMMA and the movement towards creating a free market around health care.

The conference covered a number of different aspects of the health care space and how each would benefit and are benefitting, from a free market solution. Two of our favorite speakers were the Kelley brothers, Sean and Patrick, who founded Texas Free Market Surgery Center — a platform which is similar to the Surgery Center of Oklahoma in that it provides the highest quality care to its patients at the lowest possible price, eliminating the complexity and costs of insurance bureaucracy. Sean and Patrick elaborated on the ways in which insurance companies have made it increasingly difficult for patients to get the care they need at an affordable price, and for physicians to practice without the burden of overwhelming overhead costs. Simply put, the health care system in the United States has become too complex. There is too much friction for a physician to spend the time he/she wants on actual patient care. At the core of this issue is the lack of transparency around pricing — insurance companies hide behind the veil of this complexity and have been taking advantage of patients for too long. Places like the Texas Free Market Surgery Center and the Surgery Center of Oklahoma, by foregoing insurance, are able to offer prices 30–60% lower than those incurred in Managed Care networks. Not only that, but the overhead costs are so much lower they are now able to focus entirely on the patient without having to worry about the red tape involved with submitting claims to insurance companies, or the worry that the insurance companies won’t reimburse the center. The chart below shows the delta in growth between physicians and administrators in the United States — this trend has added so much friction in the health care system that billing and insurance related (BIR) billing is approximate $70,000 per physician per year. For every doctor in a medical practice, there are four support roles to handle the billing and administrative work needed. Not only has the overhead become practically unmanageable, reimbursement rates to physicians have declined significantly (read: less pay for more work). This is simply unsustainable and can be drastically mitigated by creating a free market system that re-focuses the relationship directly between the patient and the doctor.

Due to these aforementioned trends in health care, so many physicians are moving away from the traditional Managed Care models and into direct pay. Patients love knowing exactly what they will pay for care, providers love knowing exactly what they will receive, and the friction between the two parties is significantly reduced, which leads to better care, more satisfied patients, more satisfied providers, and reduced overall medical costs. This system-wide transparency is the absolute enemy of the status quo, and will undoubtedly lead to a reduction in revenue for insurance companies who have grown way too powerful. A free market solution to health care will put money back into the hands of patients and allow them to spend it on actual care, not on insurance.

UMA is a big proponent of a free market solution for health care — in fact, it is exactly what we are building. Through the UMA platform, people can now shop for care just like they shop for anything else — search for a dentist, therapist, podiatrist, or any other type of provider based on price, distance, ratings, availability, etc. UMA has a network with some of the top providers across Manhattan, Brooklyn, Queens, and Long Island. Also, for every dollar spent through UMA, you receive 5% back in UMA dollars, which can be applied to future appointments booked through the site — and these UMA dollars never expire. If you are a provider, know that it is completely free to list your practice, and we are recruiting for all specialties.