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

  • How pediatricians can address the health problems raised in the MAHA child health report

    Joseph Barrocas, MD
  • How reforming insurance, drug prices, and prevention can cut health care costs

    Patrick M. O'Shaughnessy, DO, MBA
  • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

    AMA Committee on Economics and Quality in Medicine, Medical Student Section
  • Who gets to be well in America: Immigrant health is on the line

    Joshua Vasquez, MD
  • Online eye exams spark legal battle over health care access

    Joshua Windham, JD and Daryl James
  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Most Popular

  • Past Week

    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • How AI, animals, and ecosystems reveal a new kind of intelligence

      Fateh Entabi, MD | Tech
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • The hidden moral injury behind value-based health care

      Jonathan Bushman, DO | Physician
    • When medicine surrenders to ideology

      Anonymous | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • When medicine surrenders to ideology

      Anonymous | Physician
    • How just culture can reduce burnout and boost health care staff retention

      Olumuyiwa Bamgbade, MD | Physician
    • Why embracing imperfection makes you truly unforgettable

      Osmund Agbo, MD | Physician
    • Affordable postpartum hemorrhage solutions every OB/GYN should know

      Frank I. Jackson, DO | Conditions
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance

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

    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • How AI, animals, and ecosystems reveal a new kind of intelligence

      Fateh Entabi, MD | Tech
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • The hidden moral injury behind value-based health care

      Jonathan Bushman, DO | Physician
    • When medicine surrenders to ideology

      Anonymous | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • When medicine surrenders to ideology

      Anonymous | Physician
    • How just culture can reduce burnout and boost health care staff retention

      Olumuyiwa Bamgbade, MD | Physician
    • Why embracing imperfection makes you truly unforgettable

      Osmund Agbo, MD | Physician
    • Affordable postpartum hemorrhage solutions every OB/GYN should know

      Frank I. Jackson, DO | Conditions
    • Why kratom addiction is the next public health crisis

      Muhamad Aly Rifai, MD | Meds
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance

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...