stack of one dollar bills

A plea for transparency in pricing came the other day from the excellent Merrill Goozner, writing on The Health Care Blog.

There’s no way to have consumer-driven health care, he writes, if prices will still be opaque.

“Employers are already moving in the direction of giving consumers ‘more skin in the game,’ according to a recent survey by the Employee Benefits Research Institute. One in five Americans are already in high-deductible insurance plans, an all-time high, even though this approach is leading many to skimp on preventive services that could avoid higher health care costs down the road.

“Unfortunately for the architects of such proposals, there’s a crucial element missing from their proposals, something that is necessary to make any market work: accurate and easily accessible price information for consumers. Have you ever walked into a doctor’s office and seen a price posted for all the tests, products or procedures that might be offered during your visit? At the hospital? Ever seen a price list at the local pharmacy?”

That’s what we noticed, and the foundation of We’re bringing transparency to the health-care marketplace by telling people what things cost. Ever notice that prices for procedures on bills seem really high? Or that you think that going to the doctor or the hospital means writing a blank check? We feel that way, too.

The story he writes is right up our alley, and the comment string is also fascinating. Listen:

Paolo writes: “I have a HDHP with a fortune 100 employer. I am financially motivated to know the price of elective procedures. The plan is administered by one of the very large insurance companies. When I use the ‘pricing tools’ on the plan’s website this is what I get:

“Boston area, procedure is C-section: I get a list of 50 hospitals. There is a ‘price estimate’ for only 8 of them. The price ranges from $3000 at a no-name hospital to $10,000 at another no-name hospital. Only one of the 8 is actually in Boston. For the big-name city hospitals there is a note saying that the price is not shown at the hospital’s request. For the affiliated city and suburban hospitals the same note is shown (and no price is displayed). And for the remaining hospitals, there is apparently not enough data to get a price estimate.

“If I try carpal tunnel surgery, I get exactly ZERO results. Not enough data from some hospitals and cost not shown at the hospital’s request for the hospitals that apparently do a lot of these surgeries.”

“These ‘pricing tools’ are a good start but have a long way to go to be practical and useful to the average consumer. The day there is a health care version of people will start using it.

Dr. Mike writes: “In my little county of about 130,000 population, there are three MRI machines – one at the county hospital were it is difficult to get a price, one at the physician owned speciality hospital where if you ask they will give you a discount for cash, and another in a local neurosurgeon’s office where they are happy for the business and will readily quote a price. Again, sounds like choice to me.”

Barry Carol writes: “If I heard them correctly, UnitedHealth Group stated on its first quarter earnings conference call this morning that it will be adding enhancements to its web based medical cost estimator over the next several months that will include disclosure of actual provider contract reimbursement rates. They mentioned it in the context of choosing doctors but if it includes hospital costs as well, it could be a huge step in the right direction.”

More pleas for transparency. Can it be far away?


Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...