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Transparency is kind of irrelevant, if I'm bleeding out unconscious somewhere in the street, I'm in no position to make hospitals compete for my business. This isn't buying a new cell phone, these are peoples' lives.


Transparency is important to choose any service and care is one of them. The vast majority of healthcare services are not urgent. There's a case for price insensitivity for emergency care, but that is also resolved by choosing insurance before hand: the same way there is price sensitivity to life insurance.

A bigger problem to me than transparency is distortion: the value of the service being public means little if the patient is not paying for it. A patient that has 20% co-insurance or 20$ copay have completely different price sensititivities. They are also price-insensitive when they select insurance because they get it through the employer that picked it and payed it for them.

As a patient, the price tag on a service is relevant to you depending on insurance: validating insurance is much more important than seeing the price.

A socialized medicine scheme will have the same problem: if a patient is shielded from the actual cost of the visit, then he is more likely to use it and thus over-use it.


Well good news! Here's the entire fee schedule for the province of Ontario's socialized insurance system OHIP (http://www.health.gov.on.ca/en/pro/programs/ohip/sob/physser...) and for Quebec's system RAMQ (http://www.ramq.gouv.qc.ca/SiteCollectionDocuments/professio...). Turns out that's not mutually exclusive with a socialized system, some would say it's kind of a cornerstone. Looks like you're coming around after all ;)

Complex dermatology assessment in Ontario (A020)? $49.95CAD

I visited family in Canada and went in without insurance for a small hour-long outpatient procedure. Nothing major. They billed me $90CAD ($67USD) -- and were incredibly apologetic they charged me in the first place.

>>> A socialized medicine scheme will have the same problem: if a patient is shielded from the actual cost of the visit, then he is more likely to use it and thus over-use it.

That's the most patently absurd argument proponents of the current model utilize. This isn't some ice cream shop. Nobody goes to the doctor and demands one of each with sprinkles. If I told you all your healthcare was free what on earth would you get done?! Are you planning on shattering your femur just to maximize the value you draw from the system? If the answer is some legitimate healthcare procedure, go with God, you have my full support. If not, I'd imagine this is similar to the "5 million illegals voted last time" -- did you see one? nope! But I know in my gut they're there. Feel free to cite me some studies though.

Especially as under socialized systems medically unnecessary treatments such as purely cosmetic plastic surgeries aren't covered, for exactly this reason. This risk is further limited because most socialized systems use a Kaiser-type model where a primary care physician refers you to a specialist. Self-referring to a specialist is a very private medicine thing -- you're not a doctor, you've got no medical training, you have no idea whether you should be using the valuable time of a specialist -- let alone which one, so we defer that decision to someone who is: your GP or primary care physician. More waste reduction, cost reduction, efficiency improvement.

This horse has been beaten so long its basically a horseburger now; these are very much solved problems. By all means, have at those windmills though.




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