CARPE DIEM – Market-Based Medicine: MediBid

Medical Care in a Free MarketWhat I love about this blog is that is already has 136 comments, most of which are VERY insightful.  I’m including both the blog itself as well as some of the comments that I thought stood out.

From Professor Mark J. Perry’s Blog for Economics and Finance

The website MediBid describes itself as a new “Marketplace for Self Pay Patients to Find a Doctor or Other Medical Specialist and Deal Direct,” and here’s some info:
“Patients can find a doctor, family physician, chiropractor, dermatologist, surgeon, dentist, or any other medical specialist on MediBid.  The process is simple; patients register as “Seekers” and post a secure, private request for medical care for anything from acupuncture to total knee replacement surgery or stem cell therapy for cancer.  With thousands of registered healthcare providers, finding a doctor taking new patients such as a family physician, pain management specialist, orthopedic surgeon, ear nose and throat doctor, or other specialist is easy.  Just post a request, then browse through the profiles of qualified medical specialists that offer the procedure you are looking for.  While you browse profiles, your request will be emailed to the healthcare providers that match your unique need.  These healthcare providers will review your request and submit a custom price quote to you in the form of a Bid.  Patients can review their Bids with the profiles of the medical specialists and choose the provider that is right for them based on quality, location, availability, price, credentials, or any other attribute important to the patient. 
More than a medical directory, MediBid is a resource where medical consumers can find a doctor, then actively seek bids for the care they need. It gives physicians a direct connection to their patients. MediBid’s founders share an unrelenting drive to change the status quo in the field of healthcare financing. Focused on building strong patient-physician relationships, while supporting patients’ privacy rights and choice in the medical market place, MediBid’s goal is to provide the best opportunity for consumers to self-direct their medical care. Patients who use MediBid’s uncompromisingly unique, highly secure, needs-matching technology can acquire the best cost-to-value services anywhere.”

Larry G commented about the issue of lack of early detection, and one of my favorite oversights – the fact that people go to the ER for things that could have been handled by a primary care doc with an appointment.  This is both due to illegal immigrants as well as fear of price from anyone without insurance.  Many people without insurance don’t ‘have’ a primary care physician out of fear of price.  I know when I tried to go in as a cash patient, many doctors told me I had to have an intake exam before they would look at me for a condition or concern.  That can be a major turn off to people paying out of pocket because it means 2 separate bills.  Of course, his claim that “everyone gets care” overseas we know to be untrue.  Ask a Canadian who needed care.

the basic problem that is at the root of health care costs in this country is the fact that the medical community is incentivized to treat “conditions” rather than being outcome-based treatment of the patient where you have a primary care physician monitoring the patient and intervening as soon as things start to go side-ways.

This is how all the industrialized countries systems works.

Everyone has a primary care physician and everyone gets care early in the disease stage.

In this country, people who don’t have health insurance, don’t have a primary care physician and their diseases do not get discovered and dealt with at a state where it is less costly.

They don’t visit the doctor until something happens to them and then because they don’t have a primary care physician to start with they go to an urgent care facility – like an ER – where they – have no medical history to see their baseline and history and so s battery of tests and diagnostics are ordered – and then once the disease calibrated – more expensive – later-stage treatments.

The costs are 4-8 times more than if they had a primary care physician who intervened earlier in the process.

These increased costs are absorbed by the hospital and urgent care facilities and then cost-shifted onto the bills of those who do have insurance and this has resulted in a doubling of insurance costs in ten years and projections for them to double again in an similar time frame.

This is why our overall health care costs are about twice per capita what every other industrialized country in the world – pays.

We need to have a system in this country that is first and foremost – cost effective.

PeakTrader commented about the price increases due to the lack of a free market in the US health system.  Go PeakTrader!!

the U.S. health care system is not a free market system. If it were, the quantity and quality of health care would rise, while prices would fall.

The U.S. has a health care system where quality and prices both rise.

Europe has a system where quality and prices both fall.

Overwhelming the U.S. system with more demand will likely raise prices even more and reduce quality.

StopGovernmentMedicine added some stats as people were arguing about coverage as well as infant mortality rates.  Another user finally ended the infant mortality argument with the truth – countries do not compare apples to apples.  The amount of time required for life before deamed still-born vs. infant death differs all over the world.  Here is StopGovernmentMedicine’s comment about coverage:

1) Coverage does NOT equal access. In Canada, 96% of Canadians have coverage, yet 17.8% lack access to even a primary care physician.

2) In this country, many are uninsured because they do not see a value in “insurance”

3) Health “insurance” is expensive because medical care is expensive

4) Medical care is expensive because the third party payer system is based on price fixing through a “private-public” partnership of CMS and the AMA. It operates like a union, protecting the earnings of bad “medical providers”

5) Health “insurance” creates incentives to increase consumption (demand), while not increasing supply

And Benjamin may have given my favorite comment, basically saying let’s just throw in the towel completely:

Maybe we should go back to shamans.

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