[zeveb]

This is the real heart of the issue. There's no transparency, and the health-care 'market' is set up in order to discourage shopping altogether.

It's a shame, because a free market is the best way of insuring that resources are fairly allocated.

[barrkel]

To echo the other comment, free markets have nothing to do with fairness. Free markets use price as an information signal to allocate resources. Fairness is about ethics and justice. The is-ought problem quickly follows.

[acveilleux]

Even where there is at least gross-level of price transparency. Like in the case where you have to choose between an Urgent Care Center and an Emergency Department.

The former is much cheaper than the later in most cases. But how do you self-triage? There are 4 possible outcomes:

1. You go to an UCC and they treat you. You made the right choice and saved the most.

2. You go to an ED and they treat you but an UCC would've been enough. You made a mistake and pay more than you should.

3. You go to an ED and it was the right choice. Congratulations you saved money and got prompt care.

4. You go to an UCC, they can't treat you and refer you to an ED, you need need to pay both and quite possibly an ambulance ride for the transfer.

Now suppose you have sharp abdominal pain... Medically, the right thing to do is go to an ED (especially if you still have an appendix.) But will you gamble that the cheaper UCC is the right place? You have some chances of being right.

[jessaustin]

2. You go to an ED and they treat you but an UCC would've been enough. You made a mistake and pay more than you should.

In this case ED will often send the patient to their affiliated UCC located nearby.

[ashark]

This is probably a case where limiting choice to a smallish set of identical (save for price) options[1] that can be compared apples-to-apples would actual improve market efficiency, since the education/information imbalance is so huge and unlikely to improve otherwise. It'd also provide a lot of the same administrative cost-cutting that e.g. single-payer would, since there'd be (say) a dozen plans to check against ("does this plan cover this procedure, and at what out-of-pocket expense?") rather than... hundreds? Thousands? Dispute resolution would be easier, too.

It's what I thought the categories on the Federal exchange were aimed at accomplishing, but it turns out the range of coverage in each category is way too large to be helpful. Two "silver, low-deductible" plans can be almost nothing alike once you dig in to the fine print.

If we must keep using something more-or-less like our current system, that'd be a big help.

[1] (EDIT) I mean health insurance plans, specifically

[danharaj]

Don't say 'fair' when you mean 'efficient'.