when I need something, I usually don't have much luxury to 'shop around', and whatever price shopping you may want to try to do is often still hamstrung by 'in network' vs 'out of network' price tables.
I needed a procedure that was going to be ~$1500 at any one of a half dozen places within a 90 minute drive; some were a bit cheaper, but they couldn't see me for more than a month. There were a couple places that were ~$1100, but it basically would have been a whole day's enterprise for 2 people to get me there and back. To save maybe $400. $400 is not nothing, but I wasn't even actually 100% sure their pricing would actually be what we finally paid - no one could guarantee that. So we may have had 2 people take an entire day from earning on the partial chance of saving some money. Might even have been cheaper in another state, but then you've got travel/hotel costs to add as well.
"...no one could guarantee ..." Key phrase to be sure.
Many people that I know talk about how people need to know how much something costs - but these systems themselves don't know how much anything costs.
Furthermore, they know this and therefore unwilling to guarantee anything.
Knowing prices is great, but I feel is a non-starter when thinking about how the system can be 'fixed'. Also, you can't price shop when you're having a stroke.
All in all, we have to just acknowledge that the system for everyone is broken - beyond this, I haven't a clue as to the next step.
> Also, you can't price shop when you're having a stroke.
And you can't consent to anything when you're having a stroke, or in a car crash, or having surgery, etc. You're hit with thousands of dollars of bills when you're unconscious or not mentally competent, and it can stick with you for years.
Price shopping to keep costs down - yes, fine, it's a nice little component that would probably help a portion of our medical ecosystem. If I can save $14 on some particular medication by choice of pharmacy - sure, why not?
I've maintained for years - either single payer, and/or have insurance go to a primarily individual/family policies that people purchase themselves - get the employers out of my business. People are tied to jobs due to insurance concerns - employer-provided health insurance contributes to labor immobility. Employers have less incentive to hire less healthy people, likely keeping some people from improving their lives.
Remove 'tax deduction' for employers to provide health insurance. Ensure all taxpayers can fully deduct 'health insurance' costs from taxable income, starting from $0 (none of this 7% of MAGI bullshit). OR... increase it? 150% of your premium is deductible in year 1. 130% year 2. 115% year 3. 110% year 4. 100% year 5. Incentivize people to actually own this.
We had 18 months of "let insurance companies sell across state lines" BS during our last election. It's already possible between many states - it's simply far too much regulatory burden to deal with for most companies, that's why most aren't doing anything about it, even when they can.
REAL reform would be changing who actually pays for it - let them become the real 'consumer/customer'. An employers' incentives and mine don't always align, and if they're paying the bill...
I needed a procedure that was going to be ~$1500 at any one of a half dozen places within a 90 minute drive; some were a bit cheaper, but they couldn't see me for more than a month. There were a couple places that were ~$1100, but it basically would have been a whole day's enterprise for 2 people to get me there and back. To save maybe $400. $400 is not nothing, but I wasn't even actually 100% sure their pricing would actually be what we finally paid - no one could guarantee that. So we may have had 2 people take an entire day from earning on the partial chance of saving some money. Might even have been cheaper in another state, but then you've got travel/hotel costs to add as well.