Question: If you needed a non-emergency procedure, would you feel comfortable using the internet to have surgeons bid for your care?
The online medical auction site Medibid does just that. Patients pay a fee to post what procedure they need, then doctors bid for the job. On the website, they even use the phrase, “When doctors compete, you win.” Sound familiar? Yep, this is analogous to many industries which is why founder Ralph Weber feels it will succeed in medicine.
Will healthcare auctions work?
I think it will, but maybe not in its current form. How Medibid works is that Medibid sets up the relationship between the bidding physician and the patient and that’s where it ends. The financial details, travel arrangements, etc. are negotiated between the two parties. To be a doctor on Medibid, you need a state medical license. However, there is no real quality control determining which doctors can participate on the site. Does the doctor have privileges at a hospital? Have they had multiple malpractice suits brought against them? Where did they train? These questions are not answered. Instead, the patient is encouraged to seek out whether the physician bidding is truly qualified to perform the procedure and ensure they are reputable.
This leaves many issues to be ironed out. What happens if you live in California, travel to Texas for your procedure, then develop a complication several weeks or months later? Do you travel back? If you have insurance, will they cover a complication from a procedure obtained outside of the insurance policy? Development of supplementary insurance policies which insure the possible side effects of treatment could address some of these issues. For cosmetic surgery, companies such as CosmetAssure provide this type of insurance.
In order for healthcare auctioneer websites to succeed on a large-scale, I believe that introduction of quality control is needed. Cost is always a primary factor in any auctioneer site, but you aren’t buying a car. You are buying a service. This is why sites such as Angie’s List are so popular – they attempt to establish reputation for service providers. What makes this complicated is that medicine involves much higher stakes than having your house painted. Medibid avoids a lot of legal pitfalls with this setup (basically Craigslist in an auction setting), but for more Americans to feel comfortable with this model, physician reputation and skill verification will be necessary.
Is This New?
Not really. The auction site is a unique twist on medical tourism. Travelling far away for a cheaper surgery is nothing new. For years, you could go online and find a surgeon in another country to perform a procedure for much less than it costs in the US. In the world of plastic surgery, we hear stories about this all the time. Many plastic surgeons in the US have a decidedly negative view of “medical tourism” due to their own experiences treating patients who have had complications or poor results from taking a trip to another country. The twist is having multiple doctors compete for your care.
One advantage of Medibid is that most of the doctors are in the United States and that access to US physician information is greater than ever. Anyone with an internet connection can find out where a doctor trained, what hospitals they are affiliated with, any malpractice sanctions, and reviews from prior patients. Unfortunately, many review sites and reputations can be easily inflated to make a bad doctor look good, and that what you really find is who has the best marketing, not the best skills.
The Bottom Line
The current insurance system is broken. For patients, insurance premiums and deductibles are on the rise while coverage falls. Catastrophic plans are becoming more common. Mandates and fee increases are leaving more Americans without employer provided insurance. For doctors, the cost of practicing medicine continues to go up but the reimbursement for doing the same job declines. Governmental mandates for electronic records, pay-for-performance, and insurance denials are increasing practice overhead and costs at an alarming rate. Something has got to give.
Auctioneer healthcare websites do allow people to remove the middle man and negotiate what they deem reasonable for care. Plastic surgeons are already comfortable with this model – cosmetic surgery operates in the realm of supply and demand where prices are transparent and agreed upon in advance of treatment. A surgeon’s reputation, results, and training are intimately associated with the pricing structure. In the elective marketplace, this is a no-brainer. What sites like Medibid do are pushing the envelope into the non-elective arena of medicine and provide an alternative to the failed insurance based system.
What do you think? I’d love to hear comments on this topic from the community!