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  • Can Your State Medical Association be Trusted? September 1, 2014
    by Lee Kurisko, MD I am embarrassed to admit that I am a member of the Minnesota Medical Association. In my defense, I am automatically a member through my employer, a large radiology group based in Minneapolis. I have long …
  • Ralph Weber Talks About Healthcare Pricing – Video August 29, 2014
    Physicians used to take any type of payment for their services, be it in cash or trade (goods). The doctor would give you a price up front. Why can’t you get prices now? Insurance companies hide the real prices so …
  • Hysteria’s History Episode01 FINAL August 29, 2014
  • Ambulatory Surgical Centers: Safe & Quality Medical Care August 27, 2014
    by Adrienne Snavely Ambulatory Surgical Centers (ASC) arrived on the scene in 1970. Physicians continue to own nearly 90% of such facilities. Physicians can conveniently schedule procedures, assemble their own teams of highly skilled staff, check over the equipment and …
  • Ralph Weber Talks About Transparency – Video August 25, 2014
    Prices for medical care can vary across town, across the state, and across the country. There may be no difference in a surgical technique or the training of the physician, yet the price can differ up to 20 times as …
  • Here’s The Thing #1: Transparency August 25, 2014
  • Here’s The Thing #2: Healthcare Pricing August 25, 2014
  • Here’s The Thing #3: Procedure Cost August 25, 2014
  • Save Yourself from Your Desk Job – Part II August 22, 2014
    By Sue Redmond Studies have now shown that the “couch potato” lifestyle, and even a desk job where you are sitting for long periods of time, can heighten your risk of certain diseases and even age you faster. Joan Vernikos …
  • Want to Get Lean and Fit? Don’t Do Cardio August 20, 2014
    Want to Get Lean and Fit? Then Don’t Do Traditional “Cardio” Exercise by Lee Kurisko, MD For many, this is heresy but I believe that it is true. Have you ever noticed the people frequenting the ellipticals and treadmills at …
  • The Ebola Virus: Global Threat or False Alarm? August 18, 2014
    by Adrienne Snavely The Ebola virus was discovered in 1976 near the Ebola River, in what is now Congo. All 25 outbreaks of human illness or death have occurred thus far in Africa. In rural areas, people live close to …
  • Save Yourself From Your Desk Job! August 15, 2014
    by Sue Redmond Everyone knows that the couch potato “lifestyle” is unhealthy. You come home from a hard day at work and park yourself in front of the TV. Recent studies have found your desk job may be just as …
  • Thyroid Health & Testing August 13, 2014
    Women are more likely than men to develop thyroid disorders. Thyroid disorders that can affect women include: Hyperthyroidism Hypothyroidism Thyroid nodules Thyroiditis Thyroid cancer Goiter The most common disorders are hyper- and hypo-thyroidism. Symptoms of hyperthyroid Weight loss, even if …
  • Canadian Consumer Tax Index 2014 August 12, 2014
    Canadian families spend more money on taxes than on food, clothing, and shelter combined.The Fraser Institute’s Canadian Consumer Tax Index tracks the total tax bill of the average Canadian family from 1961 to 2013 by adding up the various taxes …
  • Keys to Exercise Success August 11, 2014
    by Lee Kurisko, MD I have had exercise as a regular habit for 41 years. Through all of that time, I have been analyzing what I do and trying to refine my approach always in search of a better way. …
  • MediBid in Kaiser Health News & Washington Post August 8, 2014
    Patients Seeking Cheaper Care Are Soliciting Bids From Doctors Online By SANDRA G. BOODMAN  AUG 05, 2014  This KHN story also ran in . It can be republished for free. (details) Francisco Velazco couldn’t wait any longer. For several years, the …
  • Are We Heading Towards a Two Tiered Health Care System? August 6, 2014
    In 2013, 117 insurance plans were offered on average in each state. Only 41 plans are offered in the exchanges, and in 16 states, consumers have access to 3 or fewer insurers.  In addition, these plans have increasingly restricted networks… …
  • OMTEC 2014 – Keynote Interview with Industry Leaders (Installment 2 of 5) August 5, 2014
    Original, essential content from OMTEC. Industry leaders Michael Butler, Dirk Kuyper and Mike Matson discuss the intricacies of supplier relationships within the orthopaedic industry.
  • OMTEC 2014 – Keynote Interview with Industry Leaders (Installment 1 of 5) August 5, 2014
    Original, essential content from OMTEC. Industry leaders Michael Butler, Dirk Kuyper and Mike Matson discuss the intricacies of supplier relationships within the orthopaedic industry.
  • Life Without Antibiotics Would Likely Be Grim August 4, 2014
    The first antibiotics came on the market after World War II. Bacteria continue to mutate so antibiotics cannot destroy them. Some have become so resistant that nothing is effective on them. A treatment that may have worked five years ago …

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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