But not for insurance companies; it's in their interest to compare hospitals and get the best care for the lowest price.
I for one hope this will trigger competition. On the other hand, it'll probably end up shafting the personnel instead of the ridiculous profit margins.
The benefit that competition provides to incentivize lower prices and better services is a consumer's ability to easily deny someone their business and go elsewhere.
What would this look like here?
Would one be in the back of an ambulance doing price shopping on a tablet as they are fighting some terrible injury?
Perhaps tie in different billing departments in a conference call as they bid over who will do the critically urgent surgery as the patient slides in and out of consciousness?
Maybe decide to have a heart attack during a winter sale special or reach into their dresser to get a coupon out as they collapse to the floor?
Or would someone be placed on a transportable life support system as they get ferried across a city deal hunting by having different procedures at different institutions, expecting them to talk to each other and string together piecemeal lab results for a coherent diagnosis?
Maybe someone would do the work beforehand, search all the popular ailments and their procedures and then do price shopping in good health and prepare an execution plan if they fall ill?
Maybe there's a non-absurd example, but I honestly can't think of it. The competition mechanism seems to be a completely unrealistic application.
What is the best answer to the "emergency care competition" that you've found?
And what proportion of medical spending is on emergency vs. not?
It's not a good model to structure the allocation in this particular instance, too many conditions are nearly impossible to satisfy. It's not a sensible way to design this market.
Dentistry is a good example of competitive service, eye care is as well. And negotiation is normal.
You're moving the goal posts in the right direction, but to the edge.
Grocery stores, sandwich shops, coffee houses, clothing stores, coin laundromats, circuit design, postal carriers, kitchen utensils and serving equipment, rental cars, housekeeping things like brooms and dustpans, bouquets and flowers, nuts bolts and fasteners, airlines...
Essentially anything where the brands are fairly indistinguishable and you have a hard time separating them. That's competition working.
Eyeglasses are probably one of the closest in medical. Common medicines like lactase, dextromethorphan and acetaminophen also score high.
The internet disrupts consumer by consumer and product by product, not industry by industry.
Going to a brick and mortar certainly appears cost prohibitive once you get used to paying $10 for stylish fitted pairs of prescription glasses.
Definitely a situation where any partial progress toward clarity and openness is a big step in the right direction. The potential for cascading changes in business practices and further reveals of all the private deals and hidden costs makes it an even better value in the future.
Pay what the insurance or medicare pays, plus a capped xx% because they got a volume discount. By law hospitals have to stabilize you, can't let you die, money or no money. (I know they have been cases of trying to dump patients but...)
So you saved me, but how did you come up with the $455,000 bill? We entered into a contract without prices, so the prices should be customary. 5-10X what insurance pays isn't fair.
Is there a current good answer to a consumer having the ability to competitively (without too much work) receive emergency care?
But then, I can imagine them charging, say, $3800 to stabilize you with whatever surgery (there goes the urgency) and start billing you normally for the rest of the care. They'll make it back and then some.
But even with emergency procedures I think you could still have effective competition based on outcomes and price. Here's an article suggesting that in some cases a poor quality hospital will triple your chance of death compared to a good hospital [0]. With more data, I could imagine a study that says, "Hospital B is so much worse for treating heart attacks than Hospital A that it is equivalent to delaying treatment by 20-25 minutes". Paramedics treating a heart attack victim would therefore have a fairly simple calculation: What is the difference between estimated time taken to reach Hospital A and estimated time taken to reach Hospital B? If more than 25 minutes you choose hospital B, if less than 20 minutes you choose Hospital A, and if between 20 and 25 minutes you choose whichever hospital historically charges the least for heart attack treatment.
[0] http://www.nytimes.com/2016/12/14/business/hospitals-death-r...