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There is no competition because there is no market transparency at all. There is also no pricing transparency, the prices aren’t even posted and you can’t know

There is no competition because there is no market transparency at all. There is also no pricing transparency, the prices aren’t even posted and you can’t know what anything costs before you get the bill. How can there ever be competition in that environment

fires10 3y ago
Most medical decisions are not shopped. It has nothing to do with competition. Quality of care is first and foremost for me. I want to live costs be damned. Only rarely will cost come into it as a decision for me. Only on things I don't need. This is for both emergency and non-emergency care. I don't know of anyone who seriously and consistently looks at costs when making medical decisions. I usually have higher priorities.
- Tostino 3y ago
  You don't know people who live near the margins then. Cost was pretty much the primary decider for me prior to making a decent living, so much so that I put off rotator cuff surgery for 10 years because I couldn't afford to have it done, no matter how much I "shopped around".
  - sokka_h2otribe 3y ago
    I think the posters comment was in a vacuum- I, too, did not consider cost when I got a surgery. It was part because costs aren't transparent, but also because the costs were the same to me after deductible. The only truly cost aware folks in the system would be Amish on community insurance funds or similar odd edge cases
- SoftTalker 3y ago
  The vast majority of medical care is not life and death. It is completely routine. It's getting vaccines, it's getting checkups, it's getting antibiotics for your sinus infection, it's getting treatment for sprains and strains. You're not going to be price-conscious on any of that? Do you go to the mayo clinic for your annual physical?
  - fires10 3y ago
    Yes, I actually go to the Mayo Clinic for primary care. It is actually cheaper than the rural doctors and hospital I live near. There is no shopping around for cost. The decision is do I trust the doctor or not. I drive to Mayo because the local doctors make to many mistakes and are not familiar enough with a variety of ailments.
- userinanother 3y ago
  The market is so non transparent you can’t shop for quality or cost. The system forces you into random provider to optimize allocation efficiency not cost or quality. You can resist that but it often means everything takes significantly longer
- Jensson 3y ago
  > Most medical decisions are not shopped .. Quality of care is first and foremost for me So you shop around for quality? That is still shopping around. If customers could try to get the highest quality for their money that also works, doesn't have to try to find the cheapest.
joe_the_user 3y ago
There is no competition because there is no market transparency at all. Wrong, there is no competition in medical care both because in the end it's not possible for lay person to make informed decisions about the spectrum of treatments available when they are under time pressure and there is no way to have choice when you have a single hospital serving a substantial area (and other ways that health care is a "natural monopoly").
- userinanother 3y ago
  Those are additional problems in some situations. But most hospital care is not immediately life threatening and people in major cities have access to 4-5 different hospitals sometimes more
fzeroracer 3y ago
They do post the prices. But how often do you actually go through and examine each code to see the prices? How do you know when you go into a hospital from an ambulance that your issue is due to say, kidney stones and not cancer? Price transparency works in an environment where a consumer knows all of the choices they have to make. For medical issues we can often only guess when it comes to critical problems, and even other protracted issues that you are aware of can be complex and hard to navigate. If you think price transparency will help then I reckon you're someone that hasn't actually been critically ill before.
- userinanother 3y ago
  The prices they post are not real prices. Nobody pays the price posted. It’s just a thing they do for compliance reasons
  - fzeroracer 3y ago
    Okay if your argument is that they're lying about prices, then how is price transparency going to help? They will keep lying about the prices, or obfuscate prices further by breaking them down into smaller pieces. Like the reason why insurance companies etc don't care about price transparency is because of the above. You're demanding something that won't work and will never work, unless the government steps in and says XYZ must cost YYY.
    - userinanother 3y ago
      They aren’t lying so much as having different price tiers for everyone. The published price is the maximum price, it’s paid for only by auto insurance companies typically. Everyone else has a negotiated lower price. Medicare prices for all would be a solution for example but doing so would both explode Medicare and bankrupt the hospitals

fires10 3y ago

Most medical decisions are not shopped. It has nothing to do with competition. Quality of care is first and foremost for me. I want to live costs be damned. Only rarely will cost come into it as a decision for me. Only on things I don't need. This is for both emergency and non-emergency care. I don't know of anyone who seriously and consistently looks at costs when making medical decisions. I usually have higher priorities.

Tostino 3y ago
You don't know people who live near the margins then. Cost was pretty much the primary decider for me prior to making a decent living, so much so that I put off rotator cuff surgery for 10 years because I couldn't afford to have it done, no matter how much I "shopped around".
- sokka_h2otribe 3y ago
  I think the posters comment was in a vacuum- I, too, did not consider cost when I got a surgery. It was part because costs aren't transparent, but also because the costs were the same to me after deductible. The only truly cost aware folks in the system would be Amish on community insurance funds or similar odd edge cases
SoftTalker 3y ago
The vast majority of medical care is not life and death. It is completely routine. It's getting vaccines, it's getting checkups, it's getting antibiotics for your sinus infection, it's getting treatment for sprains and strains. You're not going to be price-conscious on any of that? Do you go to the mayo clinic for your annual physical?
- fires10 3y ago
  Yes, I actually go to the Mayo Clinic for primary care. It is actually cheaper than the rural doctors and hospital I live near. There is no shopping around for cost. The decision is do I trust the doctor or not. I drive to Mayo because the local doctors make to many mistakes and are not familiar enough with a variety of ailments.
userinanother 3y ago
The market is so non transparent you can’t shop for quality or cost. The system forces you into random provider to optimize allocation efficiency not cost or quality. You can resist that but it often means everything takes significantly longer
Jensson 3y ago
> Most medical decisions are not shopped .. Quality of care is first and foremost for me So you shop around for quality? That is still shopping around. If customers could try to get the highest quality for their money that also works, doesn't have to try to find the cheapest.

joe_the_user 3y ago

There is no competition because there is no market transparency at all. Wrong, there is no competition in medical care both because in the end it's not possible for lay person to make informed decisions about the spectrum of treatments available when they are under time pressure and there is no way to have choice when you have a single hospital serving a substantial area (and other ways that health care is a "natural monopoly").

userinanother 3y ago
Those are additional problems in some situations. But most hospital care is not immediately life threatening and people in major cities have access to 4-5 different hospitals sometimes more

fzeroracer 3y ago

They do post the prices. But how often do you actually go through and examine each code to see the prices? How do you know when you go into a hospital from an ambulance that your issue is due to say, kidney stones and not cancer? Price transparency works in an environment where a consumer knows all of the choices they have to make. For medical issues we can often only guess when it comes to critical problems, and even other protracted issues that you are aware of can be complex and hard to navigate. If you think price transparency will help then I reckon you're someone that hasn't actually been critically ill before.

userinanother 3y ago
The prices they post are not real prices. Nobody pays the price posted. It’s just a thing they do for compliance reasons
- fzeroracer 3y ago
  Okay if your argument is that they're lying about prices, then how is price transparency going to help? They will keep lying about the prices, or obfuscate prices further by breaking them down into smaller pieces. Like the reason why insurance companies etc don't care about price transparency is because of the above. You're demanding something that won't work and will never work, unless the government steps in and says XYZ must cost YYY.
  - userinanother 3y ago
    They aren’t lying so much as having different price tiers for everyone. The published price is the maximum price, it’s paid for only by auto insurance companies typically. Everyone else has a negotiated lower price. Medicare prices for all would be a solution for example but doing so would both explode Medicare and bankrupt the hospitals