One obvious way to help drive down the cost of medical services is to encourage consumers to comparison shop, allowing them to take their business to providers who figure out how to provide the same service for less - with a minimum of hidden add-ons. If doctors or hospitals believe they can justify higher charges by pointing out how their services are better, have at it.
But the medical profession has become so ensnared in Byzantine group discounts and arcane billing codes that it's reliably reported a European tourist treated as an outpatient at a Las Vegas hospital last year offered to pay his bill on the spot, in cash - only to find no one at the hospital could tell him what he owed.
The Los Angeles Times encountered a similar wall - and reported it Sunday - when a reporter merely called 10 California hospitals and asked them what they would charge for routine gall bladder surgery (a cholecystectomy.) One hospital didn't respond at all to the inquiries, another said it would take 10 days to come up with a price and a third refused to provide a cost estimate without full details of the reporter's personal insurance coverage. The remaining seven that did come up with numbers offered such relatively useless figures as "a $1,500 facility fee" or "an $8,687 facility fee plus $900 an hour for anesthesia."
How useful are such estimates, which obviously leave out the doctors' fees?
And mind you, this is in California, which has a state law requiring hospitals to report their average charges for such procedures to the state, which then posts them on a central website.
Nevada law requires hospitals to have standard prices for each service they offer and forbids them from charging one customer more than another (NRS 439B.400). No Nevada law actually requires those price schedules to be reported to the state or posted at any central location.
But the Center for Health Information Analysis at UNLV's School of Community Health Sciences does gather such data, intended to allow informed consumers to see how Nevada hospitals are doing and what they typically bill for common procedures. Access those relevant Nevada reports online at http://chia.unlv.edu/nevadahealthchoices/html/nevadahealthchoices.htm, or http://nevadacomparecare.net/.
Local providers that post typical prices online are to be congratulated.
Consumers who can't find such information need to start asking why.