[tkiley]

> Healthcare providers must likewise be required to publish their rates in a uniform format such as industry standard CPT codes or a percentage of Medicare rates.

This proposal does not address the primary reason that price transparency is really goddamn hard: Even if you know exactly what a provider will charge for each CPT code, you don't know which CPT codes are going to be billed for a particular patient care event.

Inconsistent cost per line item is not the key problem with transparency. Tools like Castlight actually do a pretty decent job of guessing how much each item on a provider's CPT "menu" is going to cost a patient. In many (most?) situations, it is simply not possible to predict which CPT codes are going to be billed for a particular patient's care. This is the key reason price transparency tools tend to give a range rather than a specific price for a particular procedure.

(Also: Big picture, the idea that this would decrease costs by 33% is absurd. If healthcare providers had to publish real legit price sheets that were used by real consumers, prices would converge within a market, but they would not converge that low. Published pricing is not going to cause these businesses to collectively roll over and give up 33% of their revenue.)

[tehlike]

There are many factors contributing to this actually.

1. Doctors overprescribe because they are afraid of mistakenly underprescribing (we are a litigious country after all). This end up costing patients more tests/procedures, and cost doctors malpractice insurance premiums. 2. Procedures are billed differently per insurance policy. There are millions of variations of anthem PPO, and what they cover and how much they pay differs.

3. You, as the policy beneficiary, only care about your out of pocket cost. You don't really care about the price unless 1) you pay some percent of the money (reference pricing), 2) you are below your deductible.

So you are right, price transparency alone is not enough, but it is indeed a big step. If you knew in advance the price of thing, you probably wouldn't pay 400$ for a bag of saline solution [1]

[1] http://www.nytimes.com/2013/08/27/health/exploring-salines-s...

[tkiley]

> you probably wouldn't pay 400$ for a bag of saline solution

Hey, this is a great example: I might very well pay $400 for a bag of saline solution even if I knew the price in advance, because I don't care about the price of the bag. I care about the all-in cost of my treatment. If that total cost happens to include a $400 bag, I don't really care.

The "$30 Asprin" narrative sometimes misses the big picture of healthcare costs. The price of an apsrin or bag of saline solution is inflated to cover the enormous fixed costs of running a hospital with an ER. Could the ER charge $4 per bag or $0.25 per asprin? Of course, but if they lose their per-unit margin on the saline and asprin, they're going to jack up the price of some other CPT code because they have to cover their fixed costs somewhere.

[tehlike]

that's a great point, and something that is actually telling about the us healthcare.

The 400$ saline bag is probably an illustrative example, but i believe it's a pretty common line item for most surgeries. I don't know enough about medical procedures, but i assume it's not one of the rare items/prescriptions where the high cost is somewhat justified.

I care about "all-in" cost of treatment. I don't see that. I don't see that until it's too late. I don't get charged for "all-in", i get charged per individual item in that "all-in" care i got.