Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

Use the Internet to create a competitive medical marketplace

Allen Frances, MD
Health 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: Health Policy and Public Health

< 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 Health Policy

  • The next child

    Medicaid managed care and the case for mutual stewardship

    Steven Merahn, MD
  • How to build a dementia care pathway, not a referral sheet

    Gerald Kuo
  • AI in prior authorization: 3 contract questions for 2027

    Matt Hasan, PhD
  • Private equity in medicine did not kill private practice

    Brian Hudes, MD
  • Why are fewer family physicians delivering babies?

    Frista Gradica
  • Local news and public health: the segment viewers missed

    Ronald L. Lindsay, MD
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

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

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • 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...