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I think perhaps a better way to phrase it is that people aren't able to meaningfully act on price information.

nwah1 7y ago
There are some markets where price shopping is possible and does happen. For instance, LASIK prices plummeted as a result of competition and price shopping. There could be many more, if not for various policies that impede this.
- delecti 7y ago
  I think LASIK is probably closer to cosmetic surgery than "healthcare", at least as far as most of this discussion is concerned. If your arm is broken you can't really shop around.
  - nwah1 7y ago
    It takes like 5 minutes, max, to shop around for a pizza. You can easily pull up prices, reviews, and so on. If price transparency and quality comparison were made easily accessible, and one could actually choose options regardless of considerations like "in-network," then it would be entirely conceivable that the majority of medical procedures would involve price shopping. And such shopping around based on price and quality would improve things even for those who do not price shop. Feeling the pressure of market discipline would force providers to compete on quality and price. There are sites that try to be like yelp for healthcare, but you ultimately don't have any price transparency, not every doctor is listed, and you have to navigate a maze of insurance categories. In a saner world, we would have better transparency in healthcare than pizza delivery.
    - coredog64 7y ago
      My employer’s healthcare plan includes Castlight. It’s a mobile app that shows nearby in-network providers. If I need a procedure, I can search for that and get average prices.
- jessaustin 7y ago
  Dentistry is also like this. Lots of people have some dental insurance, but it doesn't cover enough of the really costly procedures to make most patients ignore costs.
eitally 7y ago
I think this is it. Imho, you essentially have two populations of patients: those with good enough jobs to have good enough insurance that their fairly price insensitive in most cases, and those who are under-employed and/or under-insured who know going in they can't afford to pay for service regardless. Neither of these groups are particularly invested in effecting change to the status quo. On the flip side, though, there is a large population in the middle where price matters a lot ... but imho these voters are overwhelmed in their PR efforts by the big spenders at the top, and the under-insured are effectively disenfranchised anyway, so their voice doesn't matter much (Medicare/Medicaid & VA services are the exception here).

There are some markets where price shopping is possible and does happen. For instance, LASIK prices plummeted as a result of competition and price shopping. There could be many more, if not for various policies that impede this.

delecti 7y ago
I think LASIK is probably closer to cosmetic surgery than "healthcare", at least as far as most of this discussion is concerned. If your arm is broken you can't really shop around.
- nwah1 7y ago
  It takes like 5 minutes, max, to shop around for a pizza. You can easily pull up prices, reviews, and so on. If price transparency and quality comparison were made easily accessible, and one could actually choose options regardless of considerations like "in-network," then it would be entirely conceivable that the majority of medical procedures would involve price shopping. And such shopping around based on price and quality would improve things even for those who do not price shop. Feeling the pressure of market discipline would force providers to compete on quality and price. There are sites that try to be like yelp for healthcare, but you ultimately don't have any price transparency, not every doctor is listed, and you have to navigate a maze of insurance categories. In a saner world, we would have better transparency in healthcare than pizza delivery.
  - coredog64 7y ago
    My employer’s healthcare plan includes Castlight. It’s a mobile app that shows nearby in-network providers. If I need a procedure, I can search for that and get average prices.
jessaustin 7y ago
Dentistry is also like this. Lots of people have some dental insurance, but it doesn't cover enough of the really costly procedures to make most patients ignore costs.

eitally 7y ago

I think this is it. Imho, you essentially have two populations of patients: those with good enough jobs to have good enough insurance that their fairly price insensitive in most cases, and those who are under-employed and/or under-insured who know going in they can't afford to pay for service regardless. Neither of these groups are particularly invested in effecting change to the status quo. On the flip side, though, there is a large population in the middle where price matters a lot ... but imho these voters are overwhelmed in their PR efforts by the big spenders at the top, and the under-insured are effectively disenfranchised anyway, so their voice doesn't matter much (Medicare/Medicaid & VA services are the exception here).