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I don't read it as "blame the consumer" but "the system is opaque". The consumer doesn't know and can't find out. Articles have been written for, I don't know,

I don't read it as "blame the consumer" but "the system is opaque". The consumer doesn't know and can't find out. Articles have been written for, I don't know, a decade or more decrying the opacity of the "Chargemaster", etc, and how if you call a hospital to ask the charge for a procedure, they probably can't give you a quote. If you have certain kinds of insurance, you're not even incentivized to care - you tolerate the opacity. But I don't think it's really blaming the consumer so much as blaming a system way off the rails.

goodells 8y ago
Obviously some situations are complicated or don't lend themselves to doing so in a timely manner, but my healthcare/insurance provider (UWHealth and Quartz) has a priceline and online message center for immediate quotes without insurance. I use it even though I have insurance, especially before appointments where I anticipate what tests the doctor is going to order. They're usually reasonable, at least by American standards. Surgery has been more difficult to pin numbers down for because of the facilities.
ryandrake 8y ago
Additionally, the first thing you have to do when you go to the doctor in the US is sign that paper that basically says “I agree to be responsible for the bill, no matter what it ends up being.” Which is ridiculous given you can’t know what the bill is until after you’re charged. Imagine going to the grocery store and there are no prices on anything. You load up your cart and walk out and the grocery store sends you a bill months later. The bill is enormous because the grocery store has a signed statement from you agreeing to pay whatever they want. That’s the system we have for healthcare.
mfringel 8y ago
The problem I have with the "blame the consumer" trope is that there's the implicit "and if consumers had full pricing knowledge, The Market(tm) would correct all of the other issues, and healthcare in the US would be fixed." I assert this mostly through anecdotal evidence based on where these conversations tend to go. I also find it to be some of the most disingenuous handwaving I've seen in recent memory. No one is going to comparison-shop when they have a ruptured appendix. Worse, if they think they can just "tough out" the abdominal pain because they can't afford the doctor visit _or the treatment that might result from it_, they'll just die. Just to head something off... if your answer to "What if people still can't afford healthcare?" is "If you can't afford healthcare, then you're not contributing enough to society to receive healthcare.", then I thank you for your candor and your ideological consistency, and have you considered that you might be a sociopath?
- dsfyu404ed 8y ago
  >The problem I have with the "blame the consumer" trope is that there's the implicit "and if consumers had full pricing knowledge, The Market(tm) would correct all of the other issues, and healthcare in the US would be fixed." I assert this mostly through anecdotal evidence based on where these conversations tend to go. If the consumer had full pricing knowledge beforehand then the market would certainly correct some of the other issues, probably not all but certainly some. Take a look at dental for example. >I also find it to be some of the most disingenuous handwaving I've seen in recent memory. No one is going to comparison-shop when they have a ruptured appendix. Worse, if they think they can just "tough out" the abdominal pain because they can't afford the doctor visit _or the treatment that might result from it_, they'll just die. Getting ripped of because you couldn't afford the time to shop around is par for the course in many industries. Yes, some peoples' appendices will rupture without warning but many more people will have conditions that give ample warning and allow comparison shopping. I think this there is a very good comparison to automotive repair in these scenarios (albeit higher dollar amounts and consumers being more willing to have work done up front to avoid more later). > a system way off the rails. I agree.

goodells 8y ago

Obviously some situations are complicated or don't lend themselves to doing so in a timely manner, but my healthcare/insurance provider (UWHealth and Quartz) has a priceline and online message center for immediate quotes without insurance. I use it even though I have insurance, especially before appointments where I anticipate what tests the doctor is going to order. They're usually reasonable, at least by American standards. Surgery has been more difficult to pin numbers down for because of the facilities.

ryandrake 8y ago

Additionally, the first thing you have to do when you go to the doctor in the US is sign that paper that basically says “I agree to be responsible for the bill, no matter what it ends up being.” Which is ridiculous given you can’t know what the bill is until after you’re charged. Imagine going to the grocery store and there are no prices on anything. You load up your cart and walk out and the grocery store sends you a bill months later. The bill is enormous because the grocery store has a signed statement from you agreeing to pay whatever they want. That’s the system we have for healthcare.

mfringel 8y ago

The problem I have with the "blame the consumer" trope is that there's the implicit "and if consumers had full pricing knowledge, The Market(tm) would correct all of the other issues, and healthcare in the US would be fixed." I assert this mostly through anecdotal evidence based on where these conversations tend to go. I also find it to be some of the most disingenuous handwaving I've seen in recent memory. No one is going to comparison-shop when they have a ruptured appendix. Worse, if they think they can just "tough out" the abdominal pain because they can't afford the doctor visit _or the treatment that might result from it_, they'll just die. Just to head something off... if your answer to "What if people still can't afford healthcare?" is "If you can't afford healthcare, then you're not contributing enough to society to receive healthcare.", then I thank you for your candor and your ideological consistency, and have you considered that you might be a sociopath?

dsfyu404ed 8y ago
>The problem I have with the "blame the consumer" trope is that there's the implicit "and if consumers had full pricing knowledge, The Market(tm) would correct all of the other issues, and healthcare in the US would be fixed." I assert this mostly through anecdotal evidence based on where these conversations tend to go. If the consumer had full pricing knowledge beforehand then the market would certainly correct some of the other issues, probably not all but certainly some. Take a look at dental for example. >I also find it to be some of the most disingenuous handwaving I've seen in recent memory. No one is going to comparison-shop when they have a ruptured appendix. Worse, if they think they can just "tough out" the abdominal pain because they can't afford the doctor visit _or the treatment that might result from it_, they'll just die. Getting ripped of because you couldn't afford the time to shop around is par for the course in many industries. Yes, some peoples' appendices will rupture without warning but many more people will have conditions that give ample warning and allow comparison shopping. I think this there is a very good comparison to automotive repair in these scenarios (albeit higher dollar amounts and consumers being more willing to have work done up front to avoid more later). > a system way off the rails. I agree.