'You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care?
If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the price.
Because of insurance. It often leads the peculiar case that a healthcare provider might have no real clue about how much a person will ultimately end up being required to pay for some procedure they're undergoing. It has no clear connection to the price that the provider will bill the insurance for.
In many developing nations insurance is the exception, rather than the rule. This changes two big things. The first is that you're expected to pay for things that would have more than a negligible cost before these procedures are done. If you don't like the cost - you go somewhere else. Emergency care, like the US, is an exception - and nobody can be turned away, so you are billed afterwards.
But the really big thing this changes is that costs are such that people can actually pay them. For instance in one procedure I had a consultation, x-ray, and medicine. Total cost was about $20, and that's not government subsidized in any way - the hospital is making profit on that cost. And this is not a "hospital" with "doctors". Most of the medical staff are educated in the west and then come back home to work afterwards. As an aside, it also means they generally have great English. It's why developing nations are increasingly a destination for medical care - 'medical tourism'.
Yeah, this has baffled me before. I remember learning in my Family & Consumer Sciences class about the importance of being an informed consumer. Then, in college I had to get a dental procedure done and I called around to try to find out the price from different dentists and no one could give me any actual numbers. I ultimately just had to pick a place based on reviews and found out the price after the fact with no knowledge of how it compared t other places.
They used to but it's dwindling. A friend of mine is a dentist and he said when he first graduated from dental school some 15 years ago, his father and his practice dealt directly with the patient and had a list of all of their prices on their website and in their office. As customers increasingly wanted to have their insurance cover dental they had fewer and fewer people paying out of pocket and going through insurance. So prices went up due to increased complexity of the business.
At my dental office, they can tell you the total cost without insurance which is the maximum they would charge for any procedure. If you paid in cash in full, they would do a discount (for non-insured).
For those insured, it depended on the insurance you had but they would give you a rough estimate based on the plan you had (mostly because they can’t be 100% certain what the insurance will cover down to the exact dollar amount.
In my experience the estimate is often off but close enough that I am not worried I’d owe an insane amount afterwards.
The current federal administration has mandated the hospitals to publish their prices online since 2019.
I have no illusions, a person without a degree in accounting probably won't be able to decipher these prices, but that could be a step in a proper direction.
List prices are not the whole information: you want to know for your insurance, how much you will get charged. And that is a completely different question.
> Why isn't their broad-based support of it for medical care?
IMHO, it is because folks are overly deferential to medical doctors.
While a lot of the problems are actually caused by the insurance industry (a constantly changing billing code system) rather than the doctors themselves, I think folks are growing tired of being yanked around by the system.
This deference is decreasing based on my limited experience (i.e., just talking to people about their medical experiences), and it may drop precipitously soon. My guess is that most/all of the good doctors going to "concierge" will be the breaking point.
> Why isn't their broad-based support of it for medical care
Because the American medical system is perhaps the finest example in the world of regulatory capture, ironically masquerading as an example of pure capitalism, while decrying the "socialism" in other countries.
> You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care?
This is not a probleam of health-care as much as it is of insurnace. If you paid doctors cash you will get straight up pricing.
Thing is the market is like 95% insurance.
I believe this will change in the near future. High-deductible plans and DPC's will bring back some sane price sensitivty into the system. But while patients with great PPO plans pay 20 bucks for a 300 dollar visit, its not going to get fixed itself by "posting prices somewhere"
Its even more absurd because your health, well being, and potentially life is held hostage. Like, if the choice is "you pay this or you die", it's not exactly a choice. They can charge whatever BECAUSE OTHERWISE YOU'RE DEAD.
But the mere fact that you can go get a surgery, and not only will you not know what it will cost, you don't even know who you're doing business with: you're going to get bills from the doctor, from the hospitals, from the nurses, from the anesthetist, and god know what else from, for the next 6 months. You don't even know if you're done paying all your bills or not!
You can't find out the price on most things and procedures that are the highest value (cancer care, dialysis, sickle-cell, etc.) are usually those with the least flexibility in price.
If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the price.