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Bernstein JRH, Bernstein J. Availability of Consumer Prices From Philadelphia Area Hospitals for Common Services: Electrocardiograms vs Parking. JAMA Intern Med. 2014;174(2):292–293. doi:10.1001/jamainternmed.2013.12538
Most people in the United States are shielded by third-party payers from the marginal cost of their health care consumption. It has been suggested that removing that shield would foment concern about price and, in turn, create market pressure to keep prices down.
Nevertheless, however concerned about prices they may be, consumers cannot act on their concerns if prices are not easily available. This point was raised by Rosenthal et al,1 who attempted to find the price for hip replacement and discovered that “many health care providers cannot provide reasonable price estimates.”
Still, it may be incorrect to extrapolate the findings of Rosenthal et al1 to all health care because hip replacement is a complex service. The price of a hip replacement may not be known in advance because costs are higher if a special implant will be needed or if the patient requires a prolonged hospital stay. Furthermore, even if hospitals know their typical cost, they may find it unwise to offer hip replacements at that figure. Owing to information asymmetry,2 hospitals selling hip replacements to all comers at their typical cost might find themselves inundated with patients who suspect that their own costs will be higher.
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