Who is "you" then in this quote: "You have medical insurance? Lovely - you will be forced to submit the claim yourself. When you visit the medical services supplier (doc, hospital, pharmacy, etc) for non-emergency services[1], you will be liable for the bill, and so you will have to lookup what that/those particular code/codes cost/s."
> know exactly what all those codes mean and their actual costs.
Why would you need to know? How does it help knowing the actual cost vs what your out-of-pocket expenses?
You get $FOO as the code and $BAR as the cost. That lets the market discover, over time, which providers are charging $BAR+$EXTRA, which insurances only cover $BAR-$uncovered.
You can't have price discovery if the purchaser is not able to determine what the price is at the point of payment. If you have a better proposal for determining what the market will bear, lets hear it.
I'm not sure where you're going with this line of questions, but the impression I get from your comments are "People will find it too confusing to know how much they are are purchasing something for - let them only discover the price of the purchase after they have already bought it".
TBH, it's never a good idea to reveal the purchase price of something only after the purchase is made. There is no justification for it.
The problem with this view is that it assumes providers have relatively few SKUs and relatively static pricing, and that providers are relatively static over time. In reality:
- medical providers have an incredibly long list of SKUs, which can have adjustments (e.g. quantity).
- pricing changes frequently
- staff changes frequently. A bill is typically not a provider charging $BAR+$EXTRA, it's more like provider A working at facility B on procedure C has Price 1, but that same provider working at facility D on the same procedure has a different Price. And all the prices are affected by the patient's insurance, and the specific contracts that were in place between the provider, the facility, and other parties at the time of service. (I'm simplifying this, in reality pricing is more complex).
It's entirely possible for Provider A to be the cheapest option in town (for a given patient-insurance combination) when a procedure is done at Facility 1, where they work Monday-Wednesday but the most expensive in town for that same patient when a procedure is done at Facility 2, where they work Thursday & Friday. This relationship can change frequently. Worse, this relationship can be subject to the specific service codes that end up being performed (all of these may not be knowable before the service begins).
I want to especially highlight the "over time" aspect as it assumes the relationships between any of these items are relatively static. In truth, it's entirely possible that your insurance carrier has a great deal for a given service this year, but next year has a terrible deal for that service at the same facility (possible because one of the underlying providers has changed). Second, it highlights the opacity in all of this. Even if you had the ability to digest all of the raw data, it's likely the outcome would not be very predictive at all for a given individual who needs to make a purchase today.
> If you have a better proposal for determining what the market will bear, lets hear it.
The market needs a lot more regulation. Think more like electric utilities instead of software.
Why would you need to know?
Serious question - how does it help to know what all those codes mean and their actual costs?
All you need to know is $INSURANCEPROVIDER only covers $100 of a bill for $CODE. What do you care what the "actual cost" of $CODE is for $MEDICALPROVIDER?
> Strange how this didn't play out in (most of) Europe.
Because what the government was able to pay was a lot less than what the US government was able to pay, because the US government provided the money (with basically no controls on cost) and then made the student liable for paying it back. This way the state didn't actually care what the purchase price was, they were always going to get it back anyway.
My understanding is that in Europe (e.g. Germany), the tuition was paid for by the state! It's not a loan, the state is not getting that money back, and so there's pressure on the state to limit what it will pay for tuition.