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Not a problem. We'll just have a pogrom every once in a while to take back our money and let off some steam.
I'm joking obviously, but the way that people on Reddit are talking about this murder is frankly concerning. These simpletons think that the reason health care is fucked up is because of insurance company profits, and if only the CEO was less evil everything would work out. Worse, they are fine with murdering this person because of their own incoherent beliefs.
Curious, why doctors rather than hospital administrators?
At least hospital administrators pay attention to how much things cost.
In many cases, doctors literally do not know how much the treatments they provide cost. This means that they simply don’t do any cost-benefit analysis. They will prescribe an expensive brand-name drug instead of a generic drug that does basically the same thing for no reason other than because they heard about it more recently.
Why is it the physicians job to know what things cost? A hospital will literally have hundreds of employees whose full-time job it is to figure out what things cost and deal with insurance companies, who are always changing things constantly. Even a small practice will usually have 2-3 employees minimum who spend most of their day figuring that stuff out.
It's entirely orthogonal to providing good medical care.
We do cost benefit analysis all the time, but it is in terms of the risks and benefits of a given intervention, wouldn't you rather us be focusing on that?
If you're not capable of doing it, then you need to figure out a workflow so that someone who is capable provides a price. This is a part of basically every other service in every other industry; it is not impossible.
To go to the auto shop example, you could equally imagine a mechanic-head praising the beauty and sanctity of the Art of
MotorcycleAutomotive Maintenance, and how carefully he considers the non-monetary risks/benefits of a given intervention, saying that in his view, the price is entirely orthogonal to providing good automotive care. He could be so educated and experienced that he thinks it would be an utter waste of his time to even put together estimates. I would say that perhaps he is right on all those points. I still want a price. I want it as a routine matter. Maybe he will have some customers who literally don't care, who have a unique, historical vehicle and a fat bank account, and they just want the artistic approach, damn the costs. But as a routine matter, I don't care how beautiful you think your orthogonal things are; you are running a service business where the customer needs to know the costs/benefits. It is doubly important in the medical domain for them to be informed of the costs/benefits if they're going to give informed consent.If you need to structure your workflow so that a different employee is up front assembling the estimate while the genius mechanic is spending every minute of his time on his craft, so be it. You have people that do that stuff anyway. Do it up front, not after-the-fact. Keep your patient informed. Just give him the damn price.
I'm curious as to why you think it would ever be in the best interests of the medical industry to provide price transparency.
Like, obviously they could develop ways to formalize price estimates and communicate them to customers. If anything, that's confirmed by the poor quality of the countervailing arguments in the thread below. But why would they ever want to?
Having the ability to inflate prices without reducing demand, because nobody at the point of consumption has any idea what anything costs, seems like a pretty sweet situation. Likewise, high salaries and various other forms of grift and waste across healthcare are made possible by the broader cultural perception that the industry provides priceless, sanctified Human Care Through Science rather than some mere grubby service like your hairdresser or auto mechanic. Giving patients the power to participate in rational cost-benefit analysis about their healthcare seems like it'd work out worse for every single level of the industry.
Total price opacity almost certainly is a benefit to the medical industry currently. As you mention, from the rest of the conversation, it's pretty clear that they have chosen this path, and it's likely because they think that it is in their own financial interest. I am extremely sympathetic to game theory arguments, and it is completely legitimate to ask why they would ever willingly give up their grip on the market.
The first, most obvious answer, is that it is the right thing to do. Doctors claim to hold themselves to high standards when it comes to informed consent. They are clearly failing miserably on that score when it comes to informing their patients about the financial parts of the costs and benefits.
Of course, one can easily observe that those sorts of considerations often get ground into dust upon first contact with the raw ability of a cartel to enrich themselves. So, a second possible reason would be if enough cultural argumentation is built up to force the conversation about informed consent and prices at a high enough level. Embarrass them, as they talk in circles. They will have to weigh the monetary gain against the loss in status as more and more people realize that they're lying and violating their stated principles in order to enrich themselves.
A third possible reason could be lawsuits to change the regulatory landscape. I've seen some lawsuits going on against hospitals who are using their boilerplate "consent to treat" forms that they use at intake to justify absolutely every charge that they choose to make, regardless of whether the patient actually agreed to that particular thing. We'll see if they go anywhere.
I described some additional possibilities here. One of the most likely possibilities is just that they are forced to change via regulation. This is not preferred, as the regulatory process is often a total mess, and it's not super likely that it will result in a truly coherent way of doing things, but when there is this much pent-up outrage at how things are currently done, it is entirely plausible that the government will just drop a bomb on them and force them to make some set of changes, regardless of whether it's in their interest, or whether those changes even make much sense.
As I argue in the linked comment, I personally think that the probabilities are trending in a way such that if they don't clean up their act, something is going to happen that is going to blow up the whole thing, with potentially highly unpredictable results. I mentioned similarly seeing the writing on the wall for the real estate and IoT industries. From a pure self-interest point of view, they have to weigh the value they would lose by voluntarily cleaning up their act in smaller ways now (in an attempt to reduce the probability of a regulatory bomb or something like that being dropped) against the expected value they'd get from a period of sticking with their guns until a bomb gets dropped plus whatever mess they get after.
Maybe I'm just a pessimist, but most of the industry-facing benefits of price opacity seem to entail a parallel set of benefits for regulators, legislators and nonprofits. If the meme that Healthcare is Priceless signs blank checks for producers in the industry, it presumably works the same way for bureaucrats and lawmakers, who get a free pass to accumulate power, expand surveillance, reward cronies and promote pet causes through selective disbursement of all that funding. And that's leaving out the large proportion of regulators/ lawmakers who are just literally in bed with parts of the industry, like the FDA folks who retire to take plum positions with Pharma.
I'm sure you could get that class to happily support selected instances of price-limiting legislation where it might hurt their political adversaries, but who's the constituency for plain consumer empowerment, beyond just Joe Q. Public?
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