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Health Care
Conference offers escape from excessive health care prices
Ray Carter | January 29, 2025
In recent decades, few people could predict the cost of even routine surgeries at most health care facilities. They knew only that prices would be shocking, potentially devastating, and ever-increasing.
But, thanks to a band of free-market innovators, that’s beginning to change. And now Oklahomans from all walks of life can learn how to avoid the pitfalls of monopolistic pricing in health care by relying on free-market providers who typically post transparent, up-front pricing.
The Free Market Medical Association (FMMA) will host its 2025 annual conference at the Omni Hotel in Oklahoma City from April 9 to April 11. This year’s theme is simple: “The Direct Care Game Changer: End the Monopoly.”
“The healthcare monopoly is over,” the FMMA website states. “Join us at the FMMA Annual Conference, where forward-thinking physicians, employers, public sector leaders, and benefits experts are driving the transformation of healthcare. Together, we’re building the new direct care ecosystem—one designed for transparency, affordability, and better outcomes.”
Dr. Keith Smith, co-founder of the Surgery Center of Oklahoma and the FMMA, said the conference is not only for medical professionals looking to inject free-market competition back into the health care market, but also business leaders and citizens looking to take control of their medical costs.
“This year’s conference, in particular, has an appeal to the layman, the person not inside of the industry,” Smith said. “The interested layman or businessman that wants a more clear look at the rigged game will learn a ton at this conference.”
The Free Market Medical Association is influencing federal policy, such as the Trump Administration’s executive order requiring upfront price reporting from hospitals that receive Medicaid or Medicare funding.
“A lot of people feel like the game is rigged, but they don’t really understand how or to what extent,” said Jay Kempton, co-founder of Kempton Group Administrators and the FMMA. “And those are certainly things they’re going to learn at the conference.”
The FMMA was created 11 years ago. Since its founding, Smith noted the group’s impact has grown nationwide, including influencing federal policy, such as the first Trump administration’s executive order requiring upfront price reporting from hospitals that receive Medicaid or Medicare funding.
The group now has 36 state chapters nationwide, and other organizations are trying to duplicate the work of the Free Market Medical Association, Smith noted.
“It has spawned copycats across the board and across the United States,” Smith said. “And I would argue that the entire price transparency buzz phrase originated with this organization and this movement.”
The Surgery Center of Oklahoma, which Smith co-founded, has long provided all-inclusive pricing on its website for major surgeries. In most cases, the surgery center’s prices are dramatically lower than the prices charged at supposedly “nonprofit” hospitals in Oklahoma and across the country.
Many Large Hospitals Resist Transparency
Organizations like the Free Market Medical Association have helped highlight the need for price transparency throughout health care, which ultimately played a role in the first Trump administration’s efforts to mandate price reporting from all major hospitals.
However, many large hospitals have resisted transparency.
According to a 2024 review conducted by PatientRightsAdvocate.org, many hospitals in Oklahoma are still not compliant with the federal price-transparency rule.
Many of those facilities have good reasons to keep prices hidden: They are making enormous profit off procedures that patients could receive elsewhere while paying far less.
A December 2023 report by PatientRightsAdvocate.org reviewed 100 hospital-pricing files nationwide and found “significant price variations for the same care at the same hospitals and across hospitals in the same states.”
Within the same hospitals, the report found prices varied by an average range of 10.7 times for the same procedures when comparing insurance-plan-negotiated rates. When reviewers compared hospitals in the same state, they found prices varied by an average range of 31.3 times.
For example, researchers found that the cash price for arthroscopic knee surgery at CHI Saint Joseph Health Hospital in Lexington, Kentucky, was $750, compared to the maximum insured negotiated rate of $37,389 at Lake Cumberland Regional Hospital in Somerset, Kentucky.
“Within monopoly, patients continue to be marginalized and are really just seen as a pawn,” Kempton said.
Under the longstanding system in which prices are opaque at best, medical debt has become a major problem that is negatively impacting the credit scores of many otherwise financially responsible Americans.
The medical professionals and health care entities involved in the Free Market Medical Association are disruptors willing to upend that system through transparent pricing. Conference participants will include healthcare sellers, purchasers, and facilitators who are leaders in the direct care movement.
Even with a smaller markup than what is the norm at many “big box” nonprofit hospitals, those providers can make a good living while producing far more value for their patients.
Smith said the 2025 conference will help citizens better understand how the system is currently stacked against the average worker and also highlight ways to avoid getting bilked.
“This monopoly-themed conference will reveal how the game is rigged for many,” Smith said. “It will reveal rules that those of us dealing with and interacting with the self-funded industry must adhere to, and it will also present a realistic lens through which monopoly in the United States can be viewed.”
“The solutions are out there,” Kempton said. “It’s just that they’re not being leveraged.”

Ray Carter
Director, Center for Independent Journalism