Princeton economist Uwe Reinhardt tracks Obamacare and health care in general. The big issue now is transparency as it applies to the costs of health care and the variation in the prices charged.
The "quest for greater transparency on health care prices is a distinctly American preoccupation," he writes.
In most other developed countries, prospective patients do not need to know the prices charged by individual providers of health care, because these are predetermined by uniform fee schedules that apply to all providers. Furthermore, cost-sharing by patients at point of service in those systems tends to be negligible. ...NYT
I don't think we should continue to coast along on the notion that we're another developed nation. We seem to have lost traction when it comes to "developed" several decades ago. From infrastructure to education, we've slipped out of the middle class, like many Americans. Same for health care costs. One of the greatest problems is what we allow providers to charge for health care and the degree of secrecy involved.
We have inconclusively debated the pros and cons of these more regulatory approaches to price setting in health care for more than half a century in this country, under the general theme of “regulation vs. market.” With the exception of Parts C (the Medicare Advantage option administered by private insurers) and D (prescription drugs, also administered by private entities), the Medicare and Medicaid programs have followed the regulatory route, although not without constant and vehement protest over government’s Soviet-style pricing policies. For Parts C and D of Medicare and the entire private health insurance market, however, we have slouched more heavily toward what some people may call a “market approach” to health care – which in reality is a grotesque caricature of how a genuinely price competitive market would operate. ...NYT
We're stuck with a system in which the costs are shrouded in secrecy and discriminative. When we haul them into the daylight, we find that the prices are off the map while the quality of the health care is debatable in a nation that no longer finds itself at the top of the "developed" list.
In a truly competitive market, both the prices and the inherent qualities of the goods or services being traded are known to all parties ahead of any trade. By contrast, in the American health care market, both the price and the quality of health care have been kept studiously hidden from patients. ...NYT
Bottom line: you get charged whatever the bill says even though someone else's bill for exactly the same goods and services is far leaner.
An effort is being made to achieve uniform quality of service and both uniformity and transparency with respect to costs. The prices must be out into the open, whether they are set by the market or by regulators.
