You go to a restaurant, peruse the menu, take your waiter’s suggestions, and order a meal. But there is something odd: the menu has no prices and you have no idea what you will be required to pay until a few weeks later when the bill arrives in the mail.
That, it turns out, is analogous to what goes on in health care, where fees are hidden at the time of service. Making matters even worse, patients often are seeking care when they are frightened and vulnerable, in no position to ask about prices or haggle.
For the most part, doctor fees are a mystery. If people see a doctor who is part of their insurance network, they are responsible only for deductibles and co-payments, and the price the health insurer pays is often a secret. And if people see a doctor outside their network, they usually have no idea what the charge will be — even though they are responsible for most of it — until the bill comes.
“This is a huge part of why expenditures are so high and why they are rising,” said Dr. Alan Garber, a health economist at Stanford University. “How can you get a market to work if no one has any idea of what the prices are?”
http://www.nytimes.com/2009/08/19/health/policy/19fees.html?_r=1&ref=health[quote=NYT article]But the only way to fix the system, Dr. Gruber said, is to make the networks better so that people will stay in them and then, most patients, knowing what it will cost them to leave their networks, will decide not to.[/quote]