Tony Chen of Hospital Impact has a good list of why price transparency won't bring the earth shattering changes advocates promise:
(1) 10% of folks make up 70% of costs. and most of them won't be subject to financial incentives, so they won't be shopping too much.
(2) lots of folks just won't have time to shop given healthcare's urgency
(3) for a lot of services that would be very "shoppable" (e.g. a nose job), a face-to-face with the doc to get an estimate is necessary, adding too much work to shop
(4) healthcare just isn't that simple; one size does not fit all; price ranges (very big ones) seem appropriate.
(5) well, the cartoon above says it. oh, and one minor detail, what about quality of care?
I think people really underestimate the quality of care issue. Who among us doesn't want to absolute best care for their loved ones? This isn't a race to the bottom, and when life and death is concerned, people aren't thinking about which hospital offers the lowest price for the angioplasty that has to be done right now. Their choices just aren't rational in this situation; it's not like when I call around to five different tailors asking how much a hem is. You also enter into a personal relationship with your doctor, and the one offering the lowest price might not give you the most confidence.
Also, we're big fans of cartoons here at Healthy Policy; head over to Tony's and see the great cartoon attached.