It’s not overpriced if there is no monopoly. No one is stopping other providers from moving to Northern California and stealing business by offering lower prices. If people want to live in a place with great weather, outdoors, food, and career opportunities, then they have to compete for it because lots of other people do too, and hence they have to compete to purchase things like homes and service from healthcare providers.

Nothing is stopping them, other than people not shopping medical procedures based on price, partly due to a complete lack of price transparency.

Maybe you could move in and set up a maternity ward and advertise it as “only $10,000!” And then people will ask what the competition charges and you won’t be able to answer. They won’t be able to answer.

I would hope it’s common knowledge nowadays, at least amongst the educated, that you should call your insurance or check their website for in network providers. I can call mine and find out how much certain procedures or codes cost, and if it’s not an exact amount, they can usually give a pretty good estimate.

Also, I would expect any service to cost 50% more in the Bay Area.

You'd do all that complicated paperwork while semi-unconscious with pain before an emergency appendectomy?

No, you do all the complicated paperwork before the emergency, so you already know exactly what to do when things go wrong.

How well things go during an emergency depends on how much effort you put into preparing ahead of time. Nothing new or strange about that.

I was referring to planned procedures such as giving birth.

Human childbirth is an amazingly complicated process with a LOT that can, and frequently does go 'wrong'. In CA, the first-birth c-section rates range from 15% to 60%, hospital depending [0]. That's 1/6th to 3/5ths of all CA first births, let alone the obvious fact that you cannot plan a birthday. Your pregnancy can go from 'low' risk to 'life-threatening' in seconds; there is no planning for this and no hospital will tell you the bills for it.

[0] http://www.chhs.ca.gov/Press%20Releases/Smart_Care_Californi...

I know all of those things can happen, but for people with health insurance, the out of pocket max will kick in at that point. But if you are healthy and want to get a lower bound on how much you'll need to pay you can request that information.

Maybe, it depends on the insurance provider; I've had ones that won't quote anything to me, not even a flu shot. Still, a lower bound is of little solace when talking about healthcare, especially your unborn child. It's the upper bound that is the issue.

Hospital stays are a whole different thing from more routine procedures. A lot of the costs are directly billed by the doctor and bypass the hospital, and hospitals don’t know what their own costs will be.

If you have insurance that covers this, it’s simple. You don’t even need to call anyone. You’ll pay your deductible.

If you want to compete on price, you’ll either need to charge substantially less than people’s dedictibles in order to make a noticeable difference, aim your price competition at insurance companies (who pay vastly lower prices already), or target the not-exactly-lucrative uninsured population.

You'll have to go back to the doctor and ask for a list of the exact ICD-10 codes that they are going to use and bill the insurance company for.

You are quite wrong about that.

https://en.m.wikipedia.org/wiki/Certificate_of_need

> A number of factors spurred states to require CONs in the health care industry. Chief among these was the concern that the construction of excess hospital capacity would cause competitors in an over-saturated field to cover the costs of a diluted patient pool by over-charging, or by convincing patients to accept hospitalization unnecessarily.

That is an incredible misunderstanding of supply-and-demand. Just, wow.

Wow! Did not know about that. So many barriers to free market...