[msbarnett]

It's a bit baffling, for someone living outside the US, why any reasonable person would have expected that sick people, of all people, would spend a lot of time comparison shopping.

The appendectomy example really underscores the insanity of the idea -- who in their right mind, when facing a burst appendix, would risk their life by stopping to do some in-depth reading of price lists to find the best deal on continuing to live?

Your only concern at that point should be getting yourself to the nearest emergency ward. It's crazy to think that you're supposed to stop and figure out if Big Al's Discount Appendectomies three towns over is having double-coupon Thursdays.

[brandonb]

Emergency care is only about 2-8% of healthcare costs. Most of what we spend on healthcare is for chronic conditions that you have for years, decades, or your lifetime.

@waynemr's comment gets it right -- the real issue is that prices are secret in healthcare, and quality metrics are nonstandardized, so there's no information on which to base your decision.

The Affordable Care Act is laying some of the groundwork for healthcare markets. For example, look at the experiments in bundled pricing that CMS is starting: http://innovation.cms.gov/initiatives/ccjr/

[Daishiman]

No dude. The real issue is that you don't consider health care to be a human right or even something that should be a high priority for wellbeing.

I have never, ever had to even think two seconds about going to a doctor for any ailment I've ever had. I would shit my pants if I had to take monetary decisions with regards to that.

[dragonwriter]

> Emergency care is only about 2-8% of healthcare costs.

Are you counting only ER costs, are counting ER costs plus the full cost of the treatment following admission from the ER. If its the former, it doesn't seem to make sense for discussing the viability of price shopping.