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

Price transparency alone won’t solve our health system’s ills

Renee Y. Hsia, MD
Policy
January 8, 2014
Share
Tweet
Share

His right testicle had jumped into his abdomen after he lost control of his motorcycle on the highway.   My 43-year-old patient, whom I’ll call Richard, in otherwise healthy condition, was brought to the ER with severe pain.  Fortunately, his testicle was still intact and only needed to be put in the proper place.

I am an attending physician in the emergency department and trauma center at San Francisco General Hospital.  I see patients who encounter unexpected medical situations and seek care during desperate times.  As someone with a bird’s-eye view of the health care system — the ER is the only place where all patients are seen regardless of their ability to pay — every day I see huge gaps in our health care system.

One of the biggest gaps is actually the way our health care system is structured. We have a fundamental market-driven approach to health care in the United States which is very American in nature — we hope the market can provide all of our needs, and we hope we can be empowered as consumers to shop for care and make decisions that force the market to respond to our needs.  One of the most touted measures has been increased price transparency as a potential solution to the current opacity and inefficiency in the health care system.  I believe this is crucial in having our health care system “own up” to our failure in providing society reasonable, cost-effective care.

At the same time, price transparency alone will not be able to solve many of our market’s ills.  Let’s take Richard’s case as an example. The root cause of the inability for the market to work in health care is because of information asymmetry, or when all parties involved in a transaction do not have relevant knowledge.

First, Richard had no idea where his testicle went. In fact, even the radiologist couldn’t identify the “unidentified heterogeneous structure in the right lower quadrant of the abdominal cavity.”

Second, Richard had no way of predicting he would be in need of medical services that day and, in fact, would not even know how to shop for this service even if he had been able to predict it beforehand.  More than that, even if he had been able to diagnose himself and knew the name of this procedure he required — “manual closed reduction of unilateral testicular dislocation” — it would have been impossible for him to “shop around” for either price or quality of the procedure to be performed. Try Googling the procedure along with the word “price” and you will not find a match for any documents. On the entire Web.

And finally, even if he were able to determine the best person to put his testicle back into place at the best price, he did not have any information on whether or not that procedure was absolutely critical to life or could be delayed or would resolve on its own.

Now let’s think about something markets do work well for — take, a laptop computer, for example.  For a particular model, I can find out what specifications it has, how much it costs, and where to buy it.  I know or can find enough information about the quality and shop around. And, perhaps most importantly, I know a critical reproductive organ is not at risk if I choose not to buy it now.

What are the options then?  To be sure, the simple existence of market failure does not mean that government will succeed.  But the contrapositive is also true: government failure does not imply markets will succeed.

Given that the United States health care system is built heavily on market principles, there is a great deal of room for the government to use its tools of regulation, financing, and even production to ensure more equitable and efficient delivery of health care services.

Debates in health care are inevitably emotionally charged and, in fact, should be, since health care is a deeply personal issue. (For those curious about Richard, we maneuvered his testicle back into his scrotum, and he — and the testicle — are now fine.)

We all agree that care should be provided — now we need to focus on the how.  Market failures mean that we have the opportunity to improve both efficiency and equity.  If we can’t get support for this level of reform, then we have much to lose as individuals and as a society.

The ball, as one might say, is in our court.

ADVERTISEMENT

Renee Y. Hsia is an emergency physician.

costs_of_care_logo_small

This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American health care delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

Prev

Flu vaccination by government mandate: A violation of HIPAA

January 8, 2014 Kevin 22
…
Next

Doctors experience the world a bit differently

January 8, 2014 Kevin 14
…

Tagged as: Emergency Medicine, Public Health & Policy, Surgery

Post navigation

< Previous Post
Flu vaccination by government mandate: A violation of HIPAA
Next Post >
Doctors experience the world a bit differently

ADVERTISEMENT

More in Policy

  • Why doctors must fight for a just health care system

    Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD
  • 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
  • Most Popular

  • Past Week

    • 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
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

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

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | 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 18 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

    • 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
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

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

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | 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

Price transparency alone won’t solve our health system’s ills
18 comments

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

Loading Comments...