Patients Turning to Online Surgical Auction Site

Surgical Rounds®, September 2014,

Patients without medical insurance who have a surgical need - such as a hernia repair, gallbladder removal, or a knee replacement - are turning to an online medical auction site.

Patients without medical insurance who have a surgical need — such as a hernia repair, gallbladder removal, or a knee replacement — are turning to an online medical auction site called Medibid. This system caters to individuals who don’t necessarily have access to traditional health insurance, use Healthcare Savings Accounts, or desire elective surgery.

For the past 4 years, Medibid has connected patients who need non-emergency care and will pay cash with doctors and facilities that offer the service they need. Medibid verifies only participating physicians’ license numbers. Patients who use the system must investigate any other credentials on their own. Medibid indicates that its Core Principles are Access, Transparency, Quality, Choice, and Privacy.

Patients create their profiles free of charge and can upload tests, images, and documents. Once they are ready to solicit bids, there is a $25 flat fee or a $4.95/month recurring charge for unlimited requests. The site assures physicians that it warns patients that bids do not cover complications. Patients can also state their spending limit or payment needs in their requests.

Physicians pay $249 annually (or $24.99/month) for unlimited access. The site lists approximately 6,000 participating doctors and surgery centers.

Once a patient submits a request for bids, the process can be as fast as a few days. Many bids cover the entire package — the facility fee, the surgeon’s fee, and anesthesia.

Medibid is controversial. Its critics indicate that the service doesn’t screen for quality, and that many of the procedures matched on Medibid are performed in lightly regulated surgical centers. Without hospital privileging committees and insurer screening, critics worry that the physicians or centers that use Medibid can be substandard.

Medibid counters that if a patient accepts a bid and later finds a performance issue with a physician or facility, it allows the patient to re-post the procedure. The site also remove physicians or facilities if it becomes aware of quality problems.

Some ethicists wonder if patients who are desperate for care are in the best position to make decisions about surgery via the internet. Although patients may have to travel hundreds of miles, the lure of surgery at less than half the price of a local operation is often enough to make it worthwhile.