Market Failure

I’ve missed a couple of blog entries. I’m sorry about that, and I want to explain why.

I’ve developed a medical issue that’s going to involve surgery. Not major surgery, mind you, but I will need anesthesia, an OR, and so on. The procedure is common, and I’m hopeful that there won’t be long-term complications. But as I’ve worked through the process of diagnosis, analysis, and preparation I’ve been taken aback by how little attention has been paid to the cost. Not just little attention—but active discouragement.

In my study I ran across a web site that compares costs at different hospitals around the country. I wasn’t surprised to see that the procedure will cost tens of thousands of dollars. Surgery isn’t cheap. But different approaches can vary in cost by over $10,000. Because insurance is paying for the procedure, not only has money not been part of the conversation, but discussions of expenses are actively discouraged. No one seems to know what the different options cost, and discussions about that never really come up, except the question as to whether insurance will cover it.

In my planning, I considered evaluating two different facilities—at least for how soon they could fit me in. But active comparison isn’t encouraged, and I’m doubtful that a second consultation would be covered—a consultation that would likely cost hundreds of dollars. Why spend hundreds out of my own pocket, when insurance is picking up the tab anyway? And my consult went well: my doctor seems a competent, experienced professional.

But if we’re concerned about the cost of health care, this is no way to run a railroad. Consumers need to be empowered and motivated to make choices. It may be that my surgeon’s approach is cost-conscious as well as effective. Or it may be the most expensive option out there. We just don’t know.

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