There is a crisis facing Americans. Individuals, their families, and employers feel overwhelmed by our current health care system. The system treats patients as if they are a number and not a name. Despite the Affordable Care Act, which was sold as the antidote for the major problems with health care in the United States, health care costs are rising and threatening families and their livelihoods. Several media outlets, including www.CNBC.com and www.foxbusiness.com,
in online articles have noted that medical bills are the biggest cause of U.S. bankruptcies. Of total bankruptcies in the U.S., 60 percent are caused by unbearable medical debt. Worse, of medical bankruptcies, 78 percent of those individuals had major medical health insurance. Clearly the problem is not lack of coverage for patients who need care.

The stories of Oklahomans suffering from health care burdens inspired the Oklahoma Council of Public Affairs to seek a state solution based in free-market principles. Much to our surprise, a health care movement was gaining momentum in our own backyard.

Many are now learning of the work of Oklahoma’s Dr. Keith Smith and his partner, Dr. Steve Lantier. These doctors are anesthesiologists who were tired of seeing the practice of medicine become increasingly opaque to the patient and the doctor, resulting in shoddier care and skyrocketing costs. Embracing a concept which has become known as Direct Care, Smith and Lantier began to post complete, bundled prices for their health care services.

Direct Care is an innovative alternative model of providing medical care that eliminates the middle man, creates affordable and predictable healthcare cost, and facilitates a direct relationship between patients and doctors. Under Direct Care, medical practices have an agreement with patients to cover a set of services through a fee or monthly membership that can be paid directly to the doctor by the patient or through their employer’s health insurance plan. In doing this, Smith and Lantier became early adopters in what is now a national movement by setting out to create a completely new type of health care facility where quality care is coupled with transparent pricing. This innovation has led to their facility, The Surgery Center of Oklahoma, being recognized both nationally and internationally as a place to find surgeries performed at one-sixth to one-tenth of the cost of typical hospitals in America. The stories of lives that Smith, Lantier, and their partners have saved through better health care and have rescued from insurmountable medical costs grows each day.

Having witnessed the savings that individuals and families experienced through the Direct Care concept, we at OCPA promoted this model as a health care solution in our 2015 Freedom Agenda for Oklahoma.

Just like most states and employers, state and local government in Oklahoma are experiencing sharply rising health care costs. Given the proven track record of Smith, Lantier, and their partners, we worked to educate the public and lawmakers about the savings that government employees would experience by embracing the concepts of Direct Care in government employee health plans. Those who benefit from gouging consumers on health care costs don’t want to see the benefits and popularity of Direct Care spread. They are working quietly to ban the private purchase of health care. In Oklahoma, OCPA worked with lawmakers, consumer advocates, and even employee unions to push against the crony capitalist interests in health care and enact protections in state law so that people can negotiate prices for health care outside of an insurance plan.

Many medical operations have begun to embrace this new method of delivering health care. In Oklahoma and across the country, doctors are creating Direct Primary Care Arrangements with their patients to cover all family practice costs at just $50 a month.

The impact is real and widespread. Smith likes to share the example of a middle-aged woman in Alaska who sought his help to repair a ventral hernia. She had first gone to her local hospital, where her son was a board member, and they quoted her $60,000 in just facility fees for this relatively simple procedure. With doctor’s fees included, the cost would have been even higher. She then discovered the Oklahoma Surgery Center’s website. Their price? $5,700, including doctor’s and facility fees. Despite her family ties to the hospital and its board, the woman and her husband flew to Oklahoma for the procedure. Her husband was so pleased with the experience that he took out an ad in the local newspaper for the Oklahoma Surgery Center. Direct care is working for patients and doctors all over the country just like it did for this woman in Alaska.

Promoters of free-market solutions in health care have a genuine opportunity to improve Americans’ quality of life by advancing the Direct Care model. OCPA found Direct Care to be an important element of a proactive agenda to advance health care solutions for Oklahoma citizens, and this year, 12 states have joined Oklahoma in taking legislative steps to allow Direct Care practices to flourish. While the Affordable Care Act continues to break promises, Direct Care is emerging as a transformative solution that will allow Americans to once again trust they will be cared for, not just covered.

Jonathan Small is the executive vice president for the Oklahoma Council of Public Affairs. Write him at jonathan@ocpathink.org.