A Menu without Prices

Alan M. Garber

doi:10.7326/0003-4819-148-12-200806170-00223

Editorials |17 June 2008

A Menu without Prices

Alan M. Garber, MD, PhD

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For the well-insured, obtaining health care in the United States is like dining in a sumptuous restaurant that has menus without prices. A price-free menu encourages diners to ignore cost when making their selections. Similarly, well-insured patients usually don't know the prices of medical services at the time they receive them. Even for common procedures, few hospitals list their charges, much less the accompanying professional fees and the out-of-pocket costs; these are only revealed weeks or months later, when the explanation of benefits statement arrives. Without prices, motivated patients cannot “shop around” for lower-cost providers of care—and even patients who knew the price could not easily learn whether the care represents good value.

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