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Comment by dv_dt | Hacker News Reader

Once you start a complex procedure, many different things can happen, some very costly to respond to. So how does an organization price for that? Do you price in every emergency contingency? Do you shop for one regular heart bypass with or without emergency resuscitation in case of heart stoppage, or extra drugs needed to be pushed in for any of a number of different outcomes. Is there a fine for not adhering to the advertised price - does that create an incentive to avoid some measures independently of what would be good treatment?

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Seems really convenient to claim that because of an edge-case that no price-transparency is possible. Americans seem to have a habit of claiming things are impossible/infeasible that plenty of other western nations have managed to implement successfully decades ago.

Edit: To clarify I am an American myself and this irritates me.

I don't claim it's impossible, but trying to point out that pricing and pretending that healthcare is like choosing one laundry detergent or another is simplistic. At the very least it pushes the complexity into trying to package a probabalistic fuzzy cloud of outcomes into a one price thing isn't an end all, and introduces all sorts of price gaming. At the very least, you increase the quoted price to cover some slice of probabilities - just like if you were a contractor quoting firm fixed price at a much higher cost.

Personally, I favor what many other nations of done and that's setting a set of fair prices through an expert panel - nations like Japan, Germany, and France do that IIRC.

You're talking about the non-shoppable expenses. Those would be handled the same way that they are now.

But most expenses are pretty predictable, like the colonoscopies that I have to get periodically (and which I do shop around for, altho it's damn difficult). Yeah, if there's a bowel perforation all bets are off, but that happens 1/1000 times.

This is the standard fallacy of "impossible to do it in 100% of every edge case means impossible to do it in 90% of common cases". Yes, in medical emergency it's impossible to put upfront price on everything. That doesn't mean one can't put known prices on thousands of more routine procedures and events - which still does not happen, or functionally does not happen - i.e. prices may exist, but they are not accessible, inquires about them are stonewalled, and every customer-facing employee is trained to say "you pay what we bill you or GTFO".

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