> In the US you get to see the cost of care every time you have reason to see the physician

I feel it's important to point out that you see the cost in the bill. There's no reliable way to see the cost beforehand.

"I feel it's important to point out that you see the cost in the bill. There's no reliable way to see the cost beforehand."

There's at least one exception:

http://surgerycenterok.com/

What's seeing the expenses going to do, what mechanism is supposed to lower cost? When you need healthcare you need healthcare. No one goes to the physician for fun, elective procedures like breast enlargement or Lasik excepted.

Well, not all healthcare procedures are emergency. If I need something done, especially that which requires many separately-billable groups, the final cost can be extensive. Right now, it's very difficult to even estimate this cost in some cases. Using that data, timing can be better planned and in some cases, compared around for other similar options. The lack of transparency in pricing until you receive the bill is a big deal, in my opinion.

For non-emergency care, knowing the cost beforehand means you can:

* Shop around

* Plan your cashflow around the healthcare expense

Some of us have more significant medical expenses than others. My prescription medications alone would be $2k/month if I had to pay it out of pocket, and that amount's pretty set in stone. The alternatives, which I've tried, don't work for me, or make symptoms worse. Shopping around wouldn't do anything for me.

There are frequently multiple providers available, and they often have wildly different costs. Some insurers have experimented with incentivizing people to choose lower-cost providers with some success. If I could easily see that provider X was even 10% cheaper than provider Y, but has comparable ratings, I would probably go with X unless it's especially inconvenient, and I'm probably less price-sensitive than most people.

The free market argument goes that informed consumers will chose healthcare services, and thus will either drive up quality, or drive down prices.

The problem is that the customers cannot see the prices, and thus can't negotiate before hand. This isn't just for emergency care, but for stuff that shouldn't be too hard to get pricing for. There's a nice Vice(?) video about a couple having a baby. They find it impossible to get even an indication of cost before hand.

This patient choice stuff made its way to England, and frankly it's dumb. People don't change their utility suppliers even though they'd save large amounts of cash. They don't change their GP unless they've moved house; they don't have enough information to make an informed choice of hospital if they need to go for surgery. It's a lot of bureaucracy that has very little benefit.

How do you account for the cost of a delivery? Do we just assume a totally fine birthing experience? What if there's complications? The emergency blood transfusion sure isn't free. It's also not predictable individually.

Ooh I know we'll calculate the cost across the mean population. Of course almost everyone has children or was a child, or knows someone who will and is invested in their well-being. And we can't account for when births happen so we need to keep facilities staffed in downturns, and account for future expensive deliveries where neonatal care is needed.

So really, the best strategy would be some scheme where we charge everyone a little - and the more people we add in the pool the smaller it'll get.

If only there were a name for such a system...

Yeah, in England the GP sometimes asks which hospital you'd prefer, and the answer is always "you're the expert, I'll do what you recommend"

People with employer provided insurance don't have much reason to figure out how much their employer is kicking in for the insurance and if they have a modest deductible they also won't care a great deal about the EOB.

I do agree that a single payer system that mandated prices would also likely result in lower prices, but I think that is less likely for the US than incremental changes to our current system.