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  • Make Spring Cleaning a Workout April 17, 2015
    Chores you do around the house and garden can burn calories and stretch and tone muscles if done correctly. Short episodes of mild exercise can improve your fitness level if done with intensity and speed. Adding 30 minutes of chores …
  • Provisioning for the Opt Out Journey April 17, 2015
    Ophthalmologist David Richardson, MD on how to prepare for opting out of Medicare. From AAPS 70th Annual Meeting, September 2013, Denver, Colorado.
  • What America’s Decline in Economic Freedom Means for Entrepreneurship and Prosperity April 16, 2015
    The United States was once considered the land of opportunity where entrepreneurs such as Henry Ford, Ray Kroc and Steve Jobs contributed to a flourishing economy by providing new products and services at prices people were happy to pay.Today America’s …
  • Obamacare Fines Debut This Tax Season April 15, 2015
    Taxes for 2014 are due this week, and your tax bill could be affected by your health insurance. If you had insurance during the entire calendar year of 2014 through an employer, a state exchange, or Medicare Part A, you …
  • Blood Transfusions: Less is More April 13, 2015
    The most common inpatient medical procedure in 2011 was the blood transfusion, with 12% of all hospitalized patients receiving one. The accrediting nonprofit Joint Commission reports transfusions as one of the five most overused hospital procedures. Now, there is a …
  • Health “Coverage” is Just a Distraction April 10, 2015
    by G. Keith Smith, MD I think it is good to be alert to any discussions that are “downstream of a flawed premise.” Let me explain. When I hear, for instance, that the “flat tax” is preferable to the current income …
  • Text Neck – Your Phone is Causing You Pain April 8, 2015
    In the last few years, more and more young people have come in for chiropractic care with symptoms of neck pain, headaches, shoulder pain, or numbness and tingling in their arms. This condition has been named “text neck”. A study …
  • Fat-Burning Foods Help with Weight Loss April 3, 2015
    Many people include losing weight as one of their personal goals. The benefits of losing weight go beyond the outward appearance. Fat-burning foods can help you lose weight, reverse diabetes and risk of obesity, and boost energy levels. Certain foods …
  • Monitoring Patient Compliance with Mobile Devices April 1, 2015
    Company iGetBetter hopes that remote patient monitoring with phone apps and wearables will reduce hospital admissions and increase patient compliance after procedures. The platform allows patients to access post-op directions on a mobile device, ask questions, and send data directly …
  • Americans Can’t Afford to Use Insurance They Own March 30, 2015
    One in three Americans have delayed medical treatment for themselves or a family member because of cost. Many patients, 25% of the non-elderly, don’t have enough cash to cover a mid-range deductible of $1,200-$2,400. These patients need to shop around …
  • Third Party Free Medical Practice Case Studies March 28, 2015
    Dr. Kathy Brown, Jack Brown, and Dr. Keith Smith speak at the 69th Annual Meeting of AAPS, September 2013. http://www.oregonderm.com/ & http://surgerycenterok.com
  • A Tale of 2 Prices…or 3?‏ March 27, 2015
    by Ralph Weber About a year and a half ago, Perry Hunt needed a hip replacement. He had been in constant pain for years and owned a construction company, and could not afford to take the 6 months off that …
  • Tisha Casida interviews Ralph Weber: Free Market Solutions to Healthcare March 25, 2015
    Tisha Casida with Rebellion.life interviews CEO of MediBid, Ralph Weber, about his work educating the public and the government about common sense health care solutions. MediBid is an online marketplace with true transparency, listing not only prices, but qualities and …
  • Small Business Coverage Uncertain Future with Association Health Plans March 23, 2015
    For the last 20 years, small businesses in Washington state have relied heavily on associations and trusts to provide healthcare insurance for their workers at lower cost than in the open market. The system is popular and works well, a …
  • Outpatient Surgery Saves Patients Time and Money March 20, 2015
    The death of Joan Rivers after a routine procedure has some asking about the safety of outpatient surgical centers. First off, it is important to make sure to know if you are a good candidate for surgery and what to …
  • Study Finds Hormones Can Help Younger Women Through Menopause March 18, 2015
    Hormone replacement therapy used to only be given to women who had completed menopause, relieving hot flashes, sleeplessness, and other symptoms. In 2009, about 8 million women used HRT, most over the age of 60. A recent Cochrane review finds …
  • Retail Health Care Clinics Multiply with Increasing Demand March 16, 2015
    Integrated care facilities offer primary care, specialty services, labs, and diagnostics all under one roof. These clinics follow a model common in Latin America. This consumer-focused type of providing medical care is gaining in popularity and increasing in number since …
  • Avoiding Caregiver Burnout March 13, 2015
    Over 43.5 million Americans care for older parents, grandparents, spouses, or other loved ones. Most family caregivers are spouses or children. The demands of caregiving can be overwhelming and can take a toll on your health, relationships, and sanity – …
  • It is Safe to Assume They Lie March 11, 2015
    by G. Keith Smith, MD I laugh every time I see headlines bragging about the number of people enrolled in “Obamacare.”  What choice to people have, after all?  ”Buy this crappy insurance plan (that you wouldn’t buy unless you were …
  • FinalHayes1 March 11, 2015

Market Based Patient Care

by Ralph Weber

Health plans are expensive because medical care is expensive. Will shopping across state lines for insurance fix that? It’s a nice sound bite, and will allow the insured to drop some of their own state mandates, but the biggest input to the cost of a health plan, is the underlying cost of the medical care financed by this plan. If you buy a plan in Shreveport, and use it in San Francisco, it will trend up in costs.

During the year-long healthcare debate, I did not hear ONE person ask why medical care is so expensive. They barely even asked why health insurance was expensive, but if 85% of the premium for health insurance must be paid out in medical costs with the new medical loss requirement, and we have not addressed the cost of medical care, then insurance premiums will CONTINUE to rise at an unsustainable rate. Enacting health insurance reform without addressing the cost of medical care, is like putting a new roof on a building which was in an earthquake.

Here’s how the Feds put the fix on health care pricing.

It all starts with a Federal agency called the Center for Medicare Services (CMS).  They set the reimbursement rates for some 14,193 medical procedures.  How they come up with these figures is based on a “secret formula” calculated like most government methods of accounting. Then CMS pays the AMA (American Medical Association) to produce and manage “secret codes” called Current Procedural Terminology codes (CPT codes).  The AMA then sells these codes to all doctors and hospitals, and insurance billing clerks.  Altogether, they receive annual income reported to be $69.9 million, to manage these codes. Insurance companies then use the reimbursement rates as a starting point in determining how much should be covered as an insurable benefit under the term, you no doubt recognize: “co-insurance”.

In any business model where prices are fixed and paid by a third party, the patient (consumer) and doctor (provider) both have an incentive to consume more services than may be needed in order to gain maximum benefit. This is why these programs have become entitlements, rather than indemnity programs. If patients travel to Kansas for a bunionectomy or to New Jersey for a knee replacement, or Oklahoma for a Coronary Artery Bypass Graft, and you allow doctors and hospitals to compete across state lines, with their own rates, THEN you will achieve fair market rates, and sustainable costs.

Each doctor and hospital has different costs for different procedures, and each medical provider includes different services with any given procedure. When a third party arbitrarily decides to pay Dr. X in Los Angeles the same as they pay Dr. Y in Miami, some doctors will be overpaid for certain procedures, and underpaid for others. Patients will receive “cost effective” procedures, which may not be what they really need. How many times have you turned on the TV and heard a vendor offer, “If you have Medicare, we’ll get it paid for, or you get your scooter free.”? Would you get one if you had to pay $25,000 of your own money? Take your car to a body shop and get an estimate to fix a dent. Then say: “oh, I forgot to mention, I have insurance”. The price will suddenly go up. This is because both the consumer and the provider are spending other people’s money.

So how can we address the costs of medical care? By allowing doctors and hospitals to compete across state lines, not just insurance companies, and by having the patient see the true cost of the care, and direct their own care. A key element completely missed in healthcare reform.

In recent years, an industry known as “Medical Tourism” has emerged, and is projected to grow at an estimated 35% per year. Medical tourism brokers send people overseas with “promised” savings which compare “billed rates” in the US to “paid rates” overseas. There often exists an added incentive for these brokers to send you overseas in the 20% to 80% or more that they get in kickbacks from the facility they send you to. These kinds of kickbacks are illegal in the US, so these brokers usually won’t refer you to a US facility. Deloitte estimates that by the year 2017 as much as $599.5 billion per year of medical care revenues could be lost from the US, in favor of overseas facilities.  There is a very important place for overseas medical facilities in caring for US patients, but they are often not competitive on price. When US doctors and hospitals are permitted to set their own rates, they can usually compete very favorably with overseas facilities. A service such as MediBid.com allows patients to shop domestically as well as internationally, and define their own criteria for medical care.

The status quo, and the reformed healthcare model lack transparency, as well as financial incentives for both provider, and consumer to reduce costs. In order to reduce costs while encouraging technological improvements, we need to introduce competition among doctors and hospitals.

Ralph F. Weber, President of MediBid, was born in Vancouver, Canada, and grew up in Thailand, Nepal, and Germany. After starting an international health insurance brokerage in Canada, Ralph’s wife was injured by a 2 ½ year wait for surgery, and his son sustained a head injury which was not treated because of the lack of a CT machine at the hospital in Canada. In 2005, Ralph moved to California to obtain surgery for his wife, and expanded his brokerage there. In 2006, Ralph participated in a healthcare forum with presidential hopeful, Rudy Giuliani. Ralph later contributed healthcare reform policy to Mayor Giuliani, and state assemblyman, Mike Villines. Driven by a passion for greater access, transparency, and value in healthcare, Ralph and a group of private investors started MediBid. MediBid does what politicians have failed to do to healthcare for decades: To control costs, expand access, and offer quality choice and value to patients through a free market system. MediBid allows patients to shop for medical for medical care in a free market system.

 

Self Funded



At MediBid, we restore market forces to medical care. Doctors get to set their own rates based on their training, experience, and outcomes, and patients get to shop for medical care across state lines and international borders. Many times with MediBid, you will find procedures that are more effective than procedures allowed, or covered by health plans. Transparency and competition are the only way to achieve reasonable costs. Many of our employer clients offering group health insurance through MediBid save $5,000 per employee per year. Those are substantial savings. Patients are saving an average of 48% vs. insurance discounted rates, or 80% vs. retail. Contact us for more information.
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