As the anecdotes offered in these threads illustrate, it is not possible to cost or value healthcare on an individual basis.

Therefore, any market for individual purchase of healthcare (whether via insurance or directly) can only have faulty price signals.

Systems based on markets with faulty price signals are wide open to manipulation.

The perpetuation of such markets is contemptible, and particularly so in the case of healthcare since there is a straight line to be drawn from dysfunctional systems to human suffering.

I don't think they necessarily make up the prices, but I wonder if there is an accounting reason for the "MSRP" on procedures being so high. I will frequently see things like a $2,000 charge to the insurance company and then it will show that they ended up paying something like $185 for the service and they disallow the rest.

Perhaps it is just to make sure they always get the max from the insurance companies. Or maybe they are able to write off the portion that the insurance company won't pay as a loss or bad debt.

I've heard explanations that it has to do with something called "pay master" software, which sets the prices - but they do set a high price as a negotiating point for insurance companies.

Personally, I believe this practice to be outright blatant fraud. There is a complete lack of price-transparency for the end-user, whether there's an insurance company involved or not. And for people who supposedly champion the so-called "Free Market", Congressional Republicans are certainly quiet on this one issue, when they're criticizing the current healthcare system and regulations.

That's what I read as well. Basically we need price transparency, insurances paying the same as the non-insured, and lower awards in law suits against hospitals/doctors and America would have one of the cheapest healthcare systems in the world in no time.

While I agree that lots of offices don't know their costs off hand, I have not had much trouble getting quotes for specific procedures.

The real problem is that I rarely have any reason to ask if my insurance is going to cover all of it.

from my limited experience with health care in the US, it seems more like a 3rd world bazaar where you haggle over it.