> How can you have competition or any kind of viable health care economy when no one actually knows the price of a service until it is set by the provider after

> How can you have competition or any kind of viable health care economy when no one actually knows the price of a service until it is set by the provider after the fact, and there is no way of offering an alternative means of offering the service? It's not that nobody actually knows the price of a service because it's set by providers after-the-fact. It's that it's infeasible to predict what an individual patient will be required to pay until after it's submitted to insurance. That generally happens before the service is provided, particularly for outpatient services or planned procedures. Providers can't feasibly predict how much patients will be responsible to pay for a whole number of reasons, one of which is that they themselves don't always know how much they'll be paid by the insurers.