What’s the single worst aspect of our current and probably future health-care system? If you ask me, it’s the fact that situations like this are possible:
[A] few months ago a doctor told me I should have a test, an angiogram, just to be safe. How much would it cost? The doctor had no idea. Nobody had any idea. If I wanted I could call up my insurance and be put on call waiting for half an hour to finally be told they had no idea. But, hey! Everybody wants to be safe, right?
Today I got the bill. Turns out it cost $7300. Who knew?
I’m not complaining that the test is too expensive. They had a big room with bright lights and computer monitors and machines going “ping!” Machines that go “ping!” cost money. I am complaining that I would have had to file a subpoena to get a ballpark figure for what it would cost. I was like, “Is it over $1000? Is it bigger than a breadbox?” Nobody knew.
How do they not know this stuff? Do they just make the numbers up afterwards?
Not enough people demand prices up front. Dr. Smith, who’s been there before, explains:
I’ve come to the conclusion that it’s the obligation of the seller to provide and display prices to the buyers. It’s not the obligation of the buyer to discover prices that are probably hidden. And in healthcare, most of the time they are. As a seller, if I say “here is what I am, here is what I do, and here is what I charge for it,” then the buyer can very deliberately determine whether that represents a value or not. They can comparison shop. And they can do it without revealing anything or providing any commitment whatsoever to me, the seller. This is present in every industry in the U.S. but it is largely absent in healthcare. Fortunately it is a growing phenomenon and more and more people are realizing that it is incumbent upon the seller to provide prices.
Worst-case scenario, which is actually the norm: prices are based on what the government will fork over.
[T]he government ultimately gets everything wrong. If they guess what my price should be, they’re either going to guess too low, which means I’m not going to provide the service, or they’re going to guess too high, which means resources are wasted.
Any attempt by anyone in a top-down central planning type of fashion to guess what the prices for services or products should be, is going to be wrong. Real prices emerge from competitive activity.
And avoiding competitive activity is at the very heart of American health care, a situation which the ACA does absolutely nothing to alleviate but then, it was never intended to.