Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Use the Internet to create a competitive medical marketplace

Allen Frances, MD
Policy
September 9, 2013
Share
Tweet
Share

An enemy intent on ruining the U.S. economy and sabotaging our public health could do no better than burden us with our current system of health care. The crushing costs of our health expenditures almost double per person those of other developed countries, with health outcomes that fall somewhere between mediocre and lousy.

There is no single cause for our medical fiasco and no single cure — especially since all solutions face the opposition of extremely powerful economic and political monopolies. The gargantuan waste built into our health care system richly feathers the nest of a medical industrial complex consisting of hospitals, doctors, the pharmaceutical industry, device makers, insurance companies, universities, businessmen, lobbyists, and politicians. All will strongly resist any changes that threaten a goose laying such golden eggs.

But there is one solution so obvious it may have a chance of success. How about using the Internet to introduce price competition? Medical pricing is so bloated because it is not transparent, not competitive, and is subject to monopolistic manipulation. The transparency and convenience of Internet posting could create competitive markets with rationalized pricing.

Much of the wasteful extravagance of U.S. health care comes from the secrecy that surrounds its pricing. You wouldn’t think of buying a car or a house or even a bar of soap without knowing what is the price and calculating its value to you.

But try getting a straight answer about how much it will cost for a stay in the hospital. And once discharged, try to make sense of (or challenge) the hundreds of mysterious items charged to you that will add up to tens of thousands of dollars for even the briefest of stays. And how can you bargain against the frequently outrageous price tags for drugs or medical devices if you feel they are necessary and you are offered no alternatives?

The prices in our health care system are way out of control (and bear no relation to cost or value) because they are secret and set by monopolies that have no competition. The usual free market forces of supply and demand don’t work when the suppliers have all the pricing power and the consumers are kept in the dark and helpless to negotiate or find a better deal.

The predictable result of this remarkably unfree medical marketplace is ridiculous high and unjustifiable profit margins. Cancer injections and orthopedic devices that cost only hundreds of dollars to produce are sold retail for tens of thousands of dollars. Hospital bills are padded and vary dramatically from facility to facility (and within facility by type of payer) in a way that has no relation to the cost or quality of services rendered. Expensive and unnecessary tests and treatments are the rule of the day.

Many other things would also need to change for us to have a truly free market in medical care. But the simplest and most obvious first step would be the routine Internet posting of comparative prices, quality measures, and consumer reviews.

The Internet has reduced the price, and increased the convenience, of shopping for just about every other product in our economy. When I want to book a plane or hotel, I turn to Kayak and get a quick comparative rundown of what’s available and how much it will cost. When I want to buy a book, I can quickly find its price and customer reviews on Amazon. Why not the have the same resource if I need a CAT scan, prostate surgery, or a diabetes workup?

It is long past time to use the Internet to inform and empower consumers and reduce the monopoly pricing power of suppliers.

The comparative prices charged by different providers for every medical procedure or service should be posted. And providers should be forced to post their prices as a precondition for inclusion in insurance plans.

The value of creating a transparent and competitive medical marketplace would seem to be the most obvious of policy no brainers — and a clear case of public benefit vs vested interest.

Allen Frances is a psychiatrist and professor emeritus, Duke University.  He blogs at the Huffington Post.

ADVERTISEMENT

Prev

Putting a human face on chronic pain

September 9, 2013 Kevin 3
…
Next

A doctor creates his own EMR out of pure survival

September 9, 2013 Kevin 15
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Putting a human face on chronic pain
Next Post >
A doctor creates his own EMR out of pure survival

ADVERTISEMENT

More by Allen Frances, MD

  • #MeToo shows why women must learn sexual self-defense

    Allen Frances, MD
  • The problem of polypharmacy in psychiatry

    Allen Frances, MD
  • Pay primary care doctors what they’re worth

    Allen Frances, MD

More in Policy

  • Unused IV catheters cost U.S. hospitals billions

    Piyush Pillarisetti
  • Why your health care dashboard isn’t working and how to fix it

    Dave Cummings, RN
  • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

    Robert E. White, Jr. & The Doctors Company
  • How new loan caps could destroy diversity in medical education

    Caleb Andrus-Gazyeva
  • Why transplant equity requires more than access

    Zamra Amjid, DHSc, MHA
  • Ideology, not evidence, fuels the anti-trans agenda

    Andie Riffer, PhD and Shawn E. Parra, LCSW, MSW
  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
    • How community and buses saved my retirement

      Raymond Abbott | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast
    • Ancient health secrets for modern life

      Larry Kaskel, MD | Conditions
    • How the internet broke the doctor-parent trust

      Wendy L. Hunter, MD | Conditions
    • Why don’t women in medicine support each other?

      Jessie Mahoney, MD | Physician
    • Why doctors need emotional literacy training

      Vineet Vishwanath | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
    • How community and buses saved my retirement

      Raymond Abbott | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast
    • Ancient health secrets for modern life

      Larry Kaskel, MD | Conditions
    • How the internet broke the doctor-parent trust

      Wendy L. Hunter, MD | Conditions
    • Why don’t women in medicine support each other?

      Jessie Mahoney, MD | Physician
    • Why doctors need emotional literacy training

      Vineet Vishwanath | Education

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Use the Internet to create a competitive medical marketplace
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...