The Human Action Podcast Dr. Keith Smith on the Health Insurance Cartel
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Feb 11, 2026 Dr. Keith Smith, an anesthesiologist who founded the Surgery Center of Oklahoma and pioneered transparent cash pricing. He recounts walking away from government reimbursement and posting all-inclusive prices online. Short sentences cover sticker-shock comparisons with hospitals. He explains why insurers resist low-cost providers. He describes barriers to scaling the model and growth of free-market medical alternatives.
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Walking Away To Control Care
- Keith Smith left lucrative anesthesiology practice to avoid unethical surgeons and control care.
- He and a partner opened Surgery Center of Oklahoma in 1997 to set all-inclusive cash prices and refuse government money.
Post All-Inclusive Prices Publicly
- Post clear, all-inclusive prices publicly to force market discipline and let buyers judge value.
- Be prepared for industry pushback but expect competitors to lower prices in response.
Sticker Shock: $19,000 Vs $1,900
- A woman without insurance was quoted $19,000 by a nearby hospital for a breast mass.
- Keith calculated an all-inclusive cash price of $1,900 and the patient chose their center instead.
