IT'S NOT A MARKET BECAUSE WE AREN'T CONSUMERS:

Dicker With Your Doc? Not So Fast…: While it’s not a bad idea to pay attention to the various costs of your medical care, the president of the Center for Advancing Health argues that haggling over costs is not a long-term solution to spiraling expenses. (Jessie Gruman, 1/25/11, Miller McCune)

The fact that health care is not a real “market” for patients is old news, although perhaps not to those journalists who blithely recommend that we set off to haggle our way to cheaper care. And it is irrelevant news to the vast majority of the public for whom discussing cost with their doctor is anathema. Many people would not consider doing so, first, because they may not know that the prices of drugs and tests vary so much by provider/source; second, because they may feel uncomfortable mentioning money concerns; and third, because the public has long held the view that more expensive care is better care and in seeking to pay less, one may be tacitly agreeing to accept less effective care.

Objectively, none of these factors should influence a person’s ability to ask straightforwardly: “I wonder if there is a way you could help me reduce the price of my care?” But our relationship with our providers is rarely objective. We come to them when we are sick and vulnerable. We put our lives in their hands. We trust them to do the best for us. And we value deeply their efforts. Haggle about the price of this commitment? Many of us will not, even if the alternatives are bankruptcy or going without care.

You don't haggle over the cost of very many consumer goods, you just make decisions about how to spend your money and that drives prices down. Since health care isn't even your own money you don't ever have to makle a choice, which drives prices up.

Posted by Orrin Judd at January 26, 2011 6:43 AM