Of course most health care is not an immediate life or death situation. Most of it is for chronic issues or routine "well care" where you would have ample time to compare prices at different providers, if there were a straightforward way to do that.
Your arm is broken and was put in a splint. To get the splint removed properly you gotta go back to the hospital for them to saw it off (and xray to determine it's a good time to saw the thing off). You're gonna... shop around and compare prices for this routine? I mean, you HAVE to get the splint off or your arm will rot off, plus, your quality of life is reduced with it on. "The Market" is armed with the knowledge that you've gotta get the thing off. Even with a couple hospital "options," the hospitals and insurance companies can collude (implicitly or otherwise) to charge basically whatever they want for the operation. The question isn't, what's a fair price, the question is, how much of this person's income can we extract before they'll risk cutting the thing off themselves.
It seems irrational to try to justify this environment when considering the needs of the citizenry. All signs point to methods of organizing healthcare that take as much power as possible from "the market" (which just means whoever can form oligopoly), be that by having a single payer system or by simply nationalizing healthcare.
As GP pointed out there are a myriad of medical/diagnostic codes, and variety of scenarios that could turn something like a baby delivery from a $5,000 affair into a $500,000 affair. Do we really expect that patient to accurately compare all the medical/diagnostic codes between providers to determine if they're getting gouged or not? Would it even be ethical to take a baby out of a NICU to try to save $50,000? We need to stop acting like healthcare is like buying a car or buying Fruity Pebbles from the store.
People aren't going bankrupt because they spent an extra $100 on a wellness visit. They're going bankrupt because of needed care that was very expensive, and even cutting the price in half or by 2/3rds would've still resulted in them going bankrupt. I guess with pricing transparency they can more confidently find out they can't afford it anywhere.
> Do we really expect that patient to accurately compare all the medical/diagnostic codes between providers
Forest for the trees. The end user doesn't need to micromanage medical codes when deciding which provider to use. They need a cost "grade" for each provider (maybe based on averages or select common procedures). Apps like Google Maps would be able to help us decide the cost versus distance equation.
Price transparency bends the cost curve down. It doesn't matter whether it is wellness or Urgent Care. So long as you are conscious, you should have information+tools to help you decide where to go. Obviously if you are arguing single-payer, that would be a different situation but since most Americans don't have that, we need to address the issues that apply to us.
Facilities mark up the drugs they provide. Pharmacies have mark-up. Price transparency helps those transactions as well.
> acute illnesses and injury that you do not have time to plan for that are the killer
Perhaps, but not for everyone. Kidney dialysis is an example of a predictable, frequent, necessary for 500,000 Americans) and expensive ($3k - $15k per month) and represents about 6% of all American healthcare spending.[1] Working price transparency for a few of the large cost drivers like dialysis would increase competition on price and reduce the total paid by patients and insurers (and thus, all insured).
> even cutting the price in half or by 2/3rds would've still resulted in them going bankrupt.
Price transparency won't fix all of the price distortions. Nobody is saying it will. But it's a necessary component of bringing prices down, along with like 80 other changes.
[1] https://healthpolicy.usc.edu/brookings-schaeffer/congress-sh...
Even if you get an idea of the price ahead of time, the price when you arrive might end up different because of your unique circumstances or maybe even just shady behavior. Yes, maybe the pricing transparency gives the patient more ammo to haggle with, but relying on sick patients to become market watchdogs just seems like the wrong horse to hitch our wagon too.
We have grocery stores with 200% markup on some goods, yet they're still in business. Price being posted doesn't mean it's affordable. Then you add in sales, coupons, rebates, discount clubs, "add to cart" pricing, SKU variations, "convenience" fees, etc... And the price listed is now no longer "the price listed". It gets even more complicated with medical systems.
It's not a certainty, but the odds are far higher than having 0 chance of shopping by phone/website, which is the way the US medical industry currently exists.
> grocery stores
Have accurate prices on every item. They calculate most of the variables at the display and all of the variables at the time of the transaction. They are a great example of somewhat complex pricing being transparent.
Grocery profit margins are tiny (usually in the 1-3% range). Sure, the occasional store and the occasional item right before a special event may bring in a larger margin, but grocery stores are an example of effective price transparency working.
Like you, I'm not hopeful that price transparency would fix much, but at least it would distinguish the "Shop-n-Save" medical center from the "Lunardi's" (premium grocers in affluent Silicon Valley suburbs) of medical centers. Right now we can't even distinguish those classes of prices across medical providers.
However that does not apply to medicine, see epipen scandal. prices can be inceeased infinitely.
Also Many medicines enjoy patent protection and thus have no competition,
Price transparency doesn't fix price fixing, broken intellectual property laws, etc. But it does increase competition in a space where opacity is currently a feature.
Americans are paying so much that medical visits to other countries are affordable. Trips to Mexico or Canada to purchase medicines. Trips to Europe to get a hip replacement.
The fact that "Medical tourism" even has a term means that Americans are searching for ways to reduce cost. Price transparency is a tool, even if it's debatable about how big the lever is.