In many developing nations insurance is the exception, rather than the rule. This changes two big things. The first is that you're expected to pay for things that would have more than a negligible cost before these procedures are done. If you don't like the cost - you go somewhere else. Emergency care, like the US, is an exception - and nobody can be turned away, so you are billed afterwards.
But the really big thing this changes is that costs are such that people can actually pay them. For instance in one procedure I had a consultation, x-ray, and medicine. Total cost was about $20, and that's not government subsidized in any way - the hospital is making profit on that cost. And this is not a "hospital" with "doctors". Most of the medical staff are educated in the west and then come back home to work afterwards. As an aside, it also means they generally have great English. It's why developing nations are increasingly a destination for medical care - 'medical tourism'.
For those insured, it depended on the insurance you had but they would give you a rough estimate based on the plan you had (mostly because they can’t be 100% certain what the insurance will cover down to the exact dollar amount.
In my experience the estimate is often off but close enough that I am not worried I’d owe an insane amount afterwards.
I have no illusions, a person without a degree in accounting probably won't be able to decipher these prices, but that could be a step in a proper direction.
IMHO, it is because folks are overly deferential to medical doctors.
While a lot of the problems are actually caused by the insurance industry (a constantly changing billing code system) rather than the doctors themselves, I think folks are growing tired of being yanked around by the system.
This deference is decreasing based on my limited experience (i.e., just talking to people about their medical experiences), and it may drop precipitously soon. My guess is that most/all of the good doctors going to "concierge" will be the breaking point.
Because the American medical system is perhaps the finest example in the world of regulatory capture, ironically masquerading as an example of pure capitalism, while decrying the "socialism" in other countries.
This is not a probleam of health-care as much as it is of insurnace. If you paid doctors cash you will get straight up pricing.
Thing is the market is like 95% insurance.
I believe this will change in the near future. High-deductible plans and DPC's will bring back some sane price sensitivty into the system. But while patients with great PPO plans pay 20 bucks for a 300 dollar visit, its not going to get fixed itself by "posting prices somewhere"
But the mere fact that you can go get a surgery, and not only will you not know what it will cost, you don't even know who you're doing business with: you're going to get bills from the doctor, from the hospitals, from the nurses, from the anesthetist, and god know what else from, for the next 6 months. You don't even know if you're done paying all your bills or not!
Its completely absurd.
Just like when you buy food! Or heating! Or water!
If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the price.