The free market exists in medicine, at least it does online with MediBid. This is where there is transparency in pricing and competition between physicians for treatments. Only when these two keys exist can a true free market function properly. In the end, both physicians and patients win.
Medicine took a wrong turn starting in the 60’s. It was then that the “product” changed from medical care to healthcare, which really meant that the “product” was payments. When we used to buy a car, the price on the window was the base price, and the options were expensive. Today, the sticker on the windo says “zero down, $299 a month”, and in these payments they include a 6 CD changer, electric locks and windows. Options we might not buy if priced separately. We buy healthcare the same way now…we buy payments. Just now we are figuring out that these payments include such things as abortions, contraception, maternity care for men, and 50 year old women, …the list goes on.
Can you buy health care the way you buy goods and services on eBay? Almost. A small, emerging online service called MediBid is letting providers bid to provide the care that patients need.
Patients must be able to pay cash. They fill out medical questionnaires; they can upload their medical records; and they can request the procedure they need. The patient’s identity is kept confidential until a transaction is consummated. MediBid-affiliated physicians and other medical providers respond by submitting competitive bids for the requested care.
Business at the site is growing. For example, last year the company facilitated:
* More than 50 knee replacements, with an average of five bids per request and some getting as many as 22. The average price was about $12,000, almost one-third of what the insurance companies typically pay and about half of what Medicare pays.
* Sixty-six colonoscopies with an average of 3 bids per request and some getting as many as six. The average price was between $500 and $800, half of what you would ordinarily expect to pay.
* Forty-five knee and shoulder arthroscopic surgeries, with average prices between $4,000 and $5,000.
* Thirty-three hernia repairs with an average price of $3,500.
MediBid facilitates the transaction, but the agreement is between doctor and patient, both of who must come to an agreement on the price and service.
One key component of all this is the willingness to travel. If you ask a hospital in your neighborhood to give you a package price on a standard surgical procedure, you will probably be turned down. After the government suppression of normal market forces for the better part of a century, hospitals are rarely interested in competing on price for patients they are likely to get as customers anyway.
A traveling patient is a different matter. This is a customer the hospital is not going to get if it doesn’t compete. That’s why a growing number of U.S. hospitals are willing to give transparent, package prices to out-of-towners; and these prices often are close to the marginal cost of the care they deliver. Interestingly, a lot of the out-of-towners getting the cut-rate prices are foreigners.
North American Surgery has negotiated deep discounts with about two dozen surgery centers, hospitals and clinics across the United States, mainly for Canadians who are unable to get timely care in their own country. The company’s cash price for a knee replacement in the United States is $16,000 to $19,000, depending on the facility a patient chooses.
But the service is not restricted to foreigners. The same economic principles that apply to the foreign patient who is willing to travel to the United States for surgery also apply to any patient who is willing to travel. That includes U.S. citizens. In other words, you don’t have to be a Canadian to take advantage of North American Surgery’s ability to obtain low-cost package prices. Everyone can do it.
The implications of all this are staggering. The United States is supposed to have the most expensive medical care found anywhere. Yet many U.S. hospitals are able to offer traveling patients package prices that are competitive with the prices charged by top-rated medical tourist facilities in such places as India, Thailand and Singapore.
All of this illustrates something many of my readers already know. Markets in medical care can work and work well — provided government gets out of the way.