Health care is a situation where competition cannot be a spur to reasonable costs because individual consumers are simply not in the position to make the kind of "free market" choices that economists (or more often free market ideologues) expect they'll make.
Moreover, the malignant and abusive US health care system is in fact a product of layer upon layer of failed "efforts to create competition" intended to reduce cost "through competition" to the point that by now all the abusers really know the dance and will be profiting next year from any further or replacement layer you add this year. (and "no regulation then!" as the US 1900 results in doctors being just heroin dealers - like my great grand father interestingly enough).
Most other industrialized nations have a state run medical system that's far superior and cheaper than the US system. They didn't solve their problem with "competition".
It was part because costs aren't transparent, but also because the costs were the same to me after deductible.
The only truly cost aware folks in the system would be Amish on community insurance funds or similar odd edge cases
So you shop around for quality? That is still shopping around.
If customers could try to get the highest quality for their money that also works, doesn't have to try to find the cheapest.
Price transparency works in an environment where a consumer knows all of the choices they have to make. For medical issues we can often only guess when it comes to critical problems, and even other protracted issues that you are aware of can be complex and hard to navigate. If you think price transparency will help then I reckon you're someone that hasn't actually been critically ill before.
Like the reason why insurance companies etc don't care about price transparency is because of the above. You're demanding something that won't work and will never work, unless the government steps in and says XYZ must cost YYY.
Medicare prices for all would be a solution for example but doing so would both explode Medicare and bankrupt the hospitals
Wrong, there is no competition in medical care both because in the end it's not possible for lay person to make informed decisions about the spectrum of treatments available when they are under time pressure and there is no way to have choice when you have a single hospital serving a substantial area (and other ways that health care is a "natural monopoly").
Europe arguably has more competition in the healthcare manufacturing and labor sectors than the US.
Europe has the same pharma and device companies. Im not aware of any country that has price controls.
What Europe has is purchasing controls. If something is too expensive, the national insurance plans simply dont buy it and dont provide it.
This is what the US lacks.
The hard truth is that, ultimately, providers, are to blame. Skilled professionals should NEVER say "I don't know how much it costs" to their clients and get away with it. It's your JOB to know how much it costs and to understand the experience of your patient. I get it that you don't WANT to know, that it's complicated and depressing. I get that because all patients get that. That is not an excuse for not paying attention to the details.
It is providers who regularly make their patients wait for hours after the appointment time. It's providers who order expensive and unnecessary tests for every condition, or who refer to multiple specialists. Each of these decisions increases the cost of care, the provider profit margin, and the stress on the patient. Because the provider is ultimately the one with the skill that the patient needs, I blame them for this systemic failure. If you're a doctor and you give in to the status quo, hire a large staff of billing agents and write scripts for all the tests and drugs you can, YOU are the problem. If you took your oath seriously, you'd never accept the way things are. Instead you advocate to maximize your profit margins instead of patient outcomes, and as a result you make the entire system sick. With any luck, it will get so sick it will die.
If you're unable, we'll take you to the one that best is equipped to deal with your issue.
HOWEVER... the insurer. If you're talking about two hospitals in the same town or part of town, no big deal. If you want to go to the hospital 15 minutes beyond that? Your insurer will deny the ambulance bill. Their argument was that "if you were sick enough to require an ambulance, you should have been transported to the closest facility, stabilized, and then transferred to your preferred facility" versus taking a longer ambulance ride.
How much is scheduled weeks in advance? how much is scheduled months in advance.
It is not as if there are other nations with formidable health care systems that are way more efficient that one could look into.
Every business, every business has people who go in with the "no matter the cost" situation. But the market sets the schedule of pricing, so if either their status is not "revealed" or the business is simply not allowed to alter the price scedule from person to person, then it is literally no different than
-A rich family deciding they'll eat at the amusement park without asking prices, and no matter what, even when a small coke has reached $10
-A guy who walks into a new restaurant after his first 48 hour fast and after payday atd decides to completely ignore the prices and just order unconditionally
-A taxi driver get a flat outside of a tire shop by pure chance and it is the start of a ten hour planned shift etc. ad Infinitum
- give as many people as possible health care
- do it in a cheap and efficient way
- without stifling innovation
If markets are a good way to do that, sure. But let me ask you one question: Who do you think will negotiate better prices for any given procedure or medication:
1. A nation-wide health insurance that makes up 90% of a companies volume
2. The solitary regular Joe who is in pain and uncertainty about their health
No need to answer me, because the numbers and real world examples already exist and this is a known market dynamic (bigger buyers can negotiate better prices). This is why patients in nations that have such systems pay sometimes multiple magnitudes less than people in the US.
Now let me ask you another question: How would you structure a health care market if your goal was to extract as much money as possible and how would it differ from what you guys already have?
If you ask me, the market for healthcare in the US work as intended. Just not for the customers.