Most importantly, ALL of this planning and sense of choice goes out the window when you have a true emergency. When that happens all that matters is getting to an ER, fast.
Yep. I was a victim of this in the -worst- way. 11 years ago I was hospitalized, and it 'just so happened' that the only doctor that would take me while I was admitted was out of network.
BCBS of Michigan in fact later settled out of court in a class action over this behavior, although the 50 or 100$ I would have gotten certainly did not make up for the hundreds of dollars that the out of network provider cost me.
There was a thread here a while back about something like an emergency-mode uber for replacing ambulances for most ER trips. Something similar might also be done for shopping for cheaper urgent care too perhaps. Say a clinic that is open late and will check out your scary rash/cough/pain without charging so much.
There will always be a trade-off between quality and cost. If you accept nothing less than highest quality (enforced by law and an extremely litigious society), then you get the US hyper-inflation of healthcare prices.
Also in the US, I think ambulances typically only have EMT's and paramedics. Though sometimes it can cost as much as the ER itself.
The point was that the hospitals are doing things behind the scenes that are not well known that affect the pricing. In this example, they charge you more for using name brand medication and then get a kickback to make money for themselves.
Just completely clueless as to how things are/operate regarding healthcare in the real world.
If you get into a car accident tomorrow driving to work, the ambulance/paramedics aren't going to ask you to do your research prior to shuttling you to a hospital to get life saving treatment. Even if you could how would you be able to tell which hospital has what price structure, what services you'll actually need given your medical condition, and what arrangements they have with various drug manufacturers and how that relates to what you require to help your condition. Save it.. "no one to blame but yourself" is so incredibly idiotic is comical.
Take something even more benign, like someone falling and breaking/straining something. Wanna still do your research first? Is it a sprain, fracture, break? How do you know? Is it clear cut? What pain medication will you need? Will you require surgery? What lab work will you need? How many tests will you need? X-rays? CAT scan? MRI? What kind of surgeon? How many nurses? Will you require blood? Whats the recovery like? What about follow up visits? Do you expect us all to practice free market principles and know all that crap in advance for price discovery before deciding to seek treatment?
True free market principles require an asymmetry of information for the system to work, and even "fathers" of the theory understood that and acknowledge the need for regulation when its absent.
True free market principles require a symmetry of information for the system to work
I would emphasize that traditional forms of conservatism were never opposed to all regulation and never embraced this libertarian worship of the unregulated market. They were opposed to collectivism, but the only remaining option isn't radical individualism. Neither are good for the individual or for society.
You Americans are getting so screwed... I got 4 separate X-ray scans done for $40 recently, modern machine, sent home with physical copies and USB, etc.
You have no idea what that person's thoughts or beliefs are...
For instance if a provider billed a patient over 100% of their stated price or over 120% the minimum price for the same item published by comparable providers, there might be some public fine or tax on the biller and rebate to the patient in proportion to the entire amount by which the patient was over-billed regardless of their insurance status.
This would possibly amount to something similar to universal public price negotiation.
But yes the idea of using pricing transparency to suppress over-billing by monopolies could possibly be interpreted as suggesting a rejection of the alternative idea of centrally fixing all consumer facing prices using a public office and then determining all government facing prices from external suppliers providing necessary inputs for the public healthcare system through minimum bid.
There is the hyper-libertarian argument which says that if someone arrives at a hospital unconcious, and the hospital bills them the maximum amount they estimate the patient can pay before bankruptcy, so the hospital can maximize initially reported earnings before writing down unpaid debts, that this is somehow a voluntarily market price as long as the hospital is private and not owned by the government, because value is purely subjective and has no relation to cost.
Then there is the other argument which says if hospitals are over-billing people which are under duress, that this is bad and we want to do something about it, but we don't want to immediately nationalize healthcare and ban private health insurance. This second type of conservatism usually focuses on price controls or regulation of monopolies.
With pricing transparency regulations, it's probably possible to implement universal public price negotiation by fining non-elective healthcare providers which bill patients over 100% of their previously published price or 120% of the minimum price published by comparable providers. Then rebate patients the entire amount they were over-billed regardless of their insurance status.
With over-billing rebates there is less need to collect payroll tax to finance social insurance premiums. Need based assistance could be financed from more progressive property taxes on the rich, and the actual price controls could be implemented relatively cheaply by randomly auditing providers to ensure compliance, by allowing patients to manually submit invoices whenever they felt they were over-billed, and by financing rebates to patients entirely from fines on providers.
It's certainly possible that other systems would work better. However if we want to be nuanced there are many different strands of U.S. conservatism. Historically U.S. conservatives subscribed to some form of cost or labor theory of value. The kind of hyper-libertarian conservative movement which says private prices are always fair is probably less than 100 years old.
I'm guessing you've never been placed on an involuntary psych hold, or woken up at a hospital after an accident left you incapacitated.
A hospital has even more lock in than the App Store. They can literally legally lock you in.