In 1973, Congress passed a law that sounded like a gift. Pay one fee, we'll cover all your medical care. The public loved it. What almost no one realized at the time was that they would never see the price of a medical service again. And when you can't see a price, you can't shop, you can't compare, and you can't win.

In this conversation, I sit down with a physician who saw exactly what was coming, walked away from a lucrative anesthesia practice in 1997, and built something almost every expert said was impossible: a facility that posts every price online, that charges a fraction of what the local hospitals charge, and that has quietly become the model that self-funded employers all over America are now flying their employees to. We talk about the counterintuitive relationship between price and quality that almost no one understands, the reason the insurance companies fought harder than the hospitals to shut him down, the surprising truth about why so-called nonprofit hospitals are still ten times more expensive than his, and the movement now spreading state by state that will decide the future of American medicine.

If you want to see what American healthcare looks like when it actually works, this is the episode.

In this episode, you'll learn:

• The 1973 law that quietly stripped every American patient of the ability to shop for their own care
• The hidden reason the cheapest healthcare in your area is almost always the highest quality, not the other way around
• The one type of buyer quietly rewriting how surgical care is priced in this country, and why the biggest hospitals in America cannot ignore them anymore

Connect with our guest Keith:

• Website: surgerycenterok.com
• Atlas Billing Company: atlasbillingcompany.com
• Free Market Medical Association: fmma.org
• X (Twitter): @SurgeryCenterOK

Chapters:

00:37 – The Anesthesiologist Who Walked Away
01:44 – The Rise Of The Administrator Class
02:48 – Bankrupting Patients For Carpal Tunnels
04:22 – The Mission That Started It All
05:31 – How To Build A Bundle In One Phone Call
08:16 – Why You Can Shop For Healthcare
09:00 – Why The Insurance Companies Fought Back Hard
11:07 – The Near-Death Experience Of 2005
13:22 – Launching The Website That Changed Everything
14:39 – The Canadians Who Showed Up First
16:06 – Undercutting Nonprofits 10 To 1
17:18 – "Not For Profit" Just Means "Doesn't Pay Tax"
19:31 – Why Physician-Led Care Wins
23:21 – The Nashville Operating Room Tragedy
26:05 – When Billing Machines Get In The Way Of Care
30:00 – Why Price And Quality Are Inverse
33:25 – The Indiana Website That Exposed Everything
37:38 – How Hospitals Spend The Overpayments
39:54 – Site Neutrality And CMS's First Real Move
42:56 – The VA Vitals Story
43:26 – If Your Doctor Works For A Hospital, They Don't Work For You
44:23 – The Free Market Medical Association
50:26 – The Patient Who Just Wanted To Pay Cash
53:11 – The Fiduciary Bomb Coming For Employers
55:57 – Smith Direct Surgical Care Goes National
59:50 – Why Self-Funded Plans Will Lead The Change
01:03:29 – Why We Need To Go Back To The Sixties
01:05:32 – Paying Surgeons What They're Worth
01:07:12 – Why We Turn Some Surgeons Off
01:09:00 – The Movement Spreading State By State
01:10:12 – Why Patients Fear Anesthesia Most