The healthcare system is often described as broken, but as Charles Sauer explained during a recent event hosted by the Mises Institute, the solutions already exist. The challenge is not creating better models of care—it’s removing the government policies that prevent them from flourishing.
Recorded on June 27 in Windham, New Hampshire, Sauer’s presentation explored how innovative healthcare entrepreneurs have built successful, patient-centered alternatives to the traditional hospital system, proving that competition, price transparency, and consumer choice can deliver better outcomes at lower costs.
Entrepreneurs Are Already Fixing Healthcare
Rather than focusing on theoretical reforms, Sauer profiled four real-world innovators who have challenged the status quo:
- Dr. Keith Smith, whose transparent pricing model at the Surgery Center of Oklahoma has demonstrated how upfront prices and competition can dramatically lower healthcare costs.
- Dr. Josh Umber, a pioneer of Direct Primary Care, who has shown that eliminating insurance middlemen strengthens the doctor-patient relationship while reducing costs.
- Dr. Francisco Rosado Madrigal, whose cash-only practice offers affordable, accessible care without the administrative burdens imposed by third-party payers.
- Medibid, an online marketplace that allows patients to receive competitive bids for medical procedures, creating market-driven pricing through reverse auctions.
Each example illustrates the same principle: when patients control healthcare dollars and providers compete for their business, prices fall, quality improves, and innovation flourishes.
Government Policies Continue to Distort the Market
While these entrepreneurs have proven that free-market healthcare works, Sauer argued that many of Washington’s policies actively discourage competition.
Among the barriers discussed were Medicare’s site-neutral payment disparities, which reward hospitals with higher reimbursements for performing the same services that independent physicians provide at lower cost. He also examined Medicare Advantage up-coding incentives and the tax treatment of employer-sponsored insurance, describing these policies as major contributors to rising healthcare costs and reduced consumer choice.
Rather than addressing these underlying distortions, policymakers too often focus on expanding government programs instead of removing the barriers preventing markets from working.
Bringing Free-Market Ideas to Capitol Hill
Drawing from his experience educating lawmakers in Washington, Sauer also discussed the challenges of translating sound economics into public policy. He noted that while innovative healthcare models are already improving patient outcomes across the country, meaningful reform often stalls because policymakers remain focused on preserving existing systems rather than empowering patients.
His message was straightforward: lasting healthcare reform will come not from additional federal intervention, but from allowing successful market-driven models to compete on a level playing field.
Watch the Full Presentation
Sauer’s presentation offers an engaging look at how entrepreneurs are already solving many of healthcare’s biggest problems—and why removing government-created barriers may be the most important reform of all.
Watch the full presentation below on the Mises Institute’s YouTube channel.
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