I think it's realist, not defeatist. More information can be good, but this doesn't mean it brings with it lower costs. It will require significant investment in aggregating & analyzing the data to make it useful. I think it is useful, but for professionals who understand the system. Alternatively it will put even more burden on the patient to coordinate their care, which is already a challenge. I assure you that you can still be incapacitated by pain or discomfort while conscious, and going line by line through medical bills to haggle over price is just not patient friendly.

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.