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They provider may not even be allowed to tell you due to contracts with insurance companies. This kind of thing is outright criminal. We need transparent pric

• prostoalex 9y ago
  Would be hard to enforce legislatively, as you're essentially forcing private companies to disclose the previously confidential pricing agreements between them and insurance companies. What will end up happening is the equivalent of MSRP in car sales - here's the list price, but since you're such a good guy, and we're running a promotion, you can get 5% off if you act today.
  • beambot 9y ago
    So instead you sign a contract to purchase a car (with no take backs!) and only then do you get told the must-pay MSRP? That's about how medical pricing works today.
    • prostoalex 9y ago
      Some states do require chargemaster transparency, e.g. https://www.oshpd.ca.gov/chargemaster/ https://www.oshpd.ca.gov/chargemaster/
  • mikeash 9y ago
    Why would that be hard? I thought law takes precedence over contracts. Even having the equivalent of car MSRPs would be a huge improvement. As it stands today, you often cannot get any price for a procedure beforehand, not even a "forget about insurance, I'm just going to pull out a wad of benjamins and start counting until you tell me it's enough" price. Plus, car prices don't vary that much from MSRP. I can look up a car's MSRP and know that this is approximately what I'll pay. If I get a really good deal I might get away with paying 10-20% less. If the car is in extremely high demand, I might have to pay 10-20% more. But I can get a pretty decent idea. Medical pricing often varies by a factor of ten depending on whether you have insurance, and which provider it is.
    • prostoalex 9y ago
      I posted a link below, but some states already mandate chargemaster transparency. It's close to useless, as one quickly discovers that (a) pretty much any procedure costs a trillion dollars, but discounts apply and (b) the consumer's view of "procedure" and hospital system's view of "services provided" differ radically, as every gauze used up, every vital measurement, and every painkiller is a billing item in hospital's book (cost of goods and labor), but are integral part of the "procedure" the way the consumer sees it.
      • mikeash 9y ago
        That some current laws are useless doesn't mean better laws couldn't be made. Mandate a final, guaranteed, all-inclusive price, or require disclosing every single discount made available to anybody, or even require charging the same price to everybody. I think the real problem is that Americans mostly aren't willing to have their government going around telling businesses to cut out their shit or else.
        • prostoalex 9y ago
          I don't know if there are simple one-step solutions. > Mandate a final, guaranteed, all-inclusive price How would that work for something like birth? Depending on the amount of time spent in labor and a host of potential complications (some requiring presence of additional doctors like anesthesiologists or surgeons to perform a C-section) the costs will vary greatly. > require disclosing every single discount made available to anybody, or even require charging the same price to everybody That could work, as long as discounts don't evolve into kickbacks or rebates, but then why should an insurance company that signed up 10 customers receive the same discount as an insurance company that sent 100,000 people? The latter loses their leverage, which typically sends the prices up, not down.
          • mikeash 9y ago
            It's definitely not simple, but I'm confident that it can be done. For something like birth, you'd have a baseline, then extras for various contingencies. Why should an insurance company that signed up 10 customers get the same price as one that signed up 100,000? Because health care is fundamentally incompatible with free market capitalism (information asymmetry is extreme, demand curves are whacked, and there's often no competition due to time constraints) so allowing this sort of thing just leads to monopolies. To put it another way, they should receive the same discount because if they don't, the smaller insurance company will go out of business and we'll ultimately be left with a few gigantic ones who use their market position to simultaneously squeeze hospitals and customers. Aren't there single-payer systems where medical care is still private, and the government pays them for services? I doubt those systems would put up with "we'll tell you how much you have to pay when we're done" so I'm sure there are examples to follow.