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  • Few Patients Use Quality, Price Information To Make Health Decisions April 24, 2015
    by Jordan Rau, Kaiser Health News Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according to a poll released Tuesday. Prices for …
  • Shopping Tools Save Patients Cash on Medical Care April 22, 2015
    Vicki Burns of New Mexico needed a total hip replacement in 2012, but could not afford the hospital’s non-negotiable cash estimate of $79,000. Within two days of placing a patient request on MediBid, she received two bids. She chose a …
  • Hysteria’s History Episode 3 April 21, 2015
  • 20th Century Experiment Attempts to Turn Back Time April 20, 2015
    Ellen Langer, a Harvard psychologist, conducted a radical experiment in 1979 – the results of which were never published. Last fall, this study was featured in the New York Times. The study examined how aging’s effects could be altered or …
  • https://youtube.com/devicesupport April 17, 2015
  • 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 …

Your Disease Can Kill You in More than One Way

by G. Keith Smith, MD

I’ve been asked a lot lately about “outcomes.”  The federal government is going to start paying physicians based on outcomes, it seems.  ”Outcome-based medicine” is a recipe for disaster.  Here’s why.

Patients are all different.  Contrary to what Washington bureaucrats believe, treatment must be individualized for individual patients.  That means that outcomes are going to be only partially under the control of the physician.  We had a patient that developed a foot infection years ago because she found that her pain was best relieved after her bunion surgery if she let her small dog lick her wounds.  Yet according to the brainiacs in D.C., this wound complication would reduce our payment for the care provided!

Now put yourself in the physician’s shoes.  He now knows that he is going to be “graded” and paid for his outcomes.  What chance does the patient with multiple system failure, someone whose likelihood of a good outcome is bleak if everything is done perfectly, have getting in to see a doctor?  If you are seeing this as a rationing tool you get a gold star!

“I’m not about to operate on that train wreck!”  ”It will kill my numbers!”  Can’t you just hear the talk in the doctor’s lounge?  Physicians employed by hospitals will be the first to run from the tough patients and the tough cases, as their loyalty is to their boss, not the patient.

Paradoxically, doctors who are doing sham surgery will be the ones with the best outcomes, as their patients, many of whom don’t need surgery in the first place, will exhibit great, basically perfect outcomes.  Physicians who don’t do unnecessary surgery will be pushed to do so to improve their “scores.”

“Pay for performance” trends in medicine are not a good idea in my opinion.  Paying based on patient outcomes will have perverse effects, not the least of which will be the complete denial of care to the very sick.



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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