Yesterday, I was reviewing claims for a manufacturing company. One claim stood out as emblematic of the challenges people have being good healthcare consumers. Here's a classic example of price failure:
An employee had a common blood chemistry test, called Comprehensive Metabolic Profile, done at the outpatient department of a prestigious referral health system. Other specialized tests were done at the same time. The "list" price for blood chem was $978 and the PPO allowable was $625.
This employee could have had the blood chem test done at a local lab nearby (full price less than $10) and had a copay less than a cup of coffee at Starbucks. Instead, this employee had $125 out-of-pocket.
I wonder if anyone had an honest conversation about price with this employee before lab was drawn?
Why does the national conversation focus on the cost of insurance and not the cost of care itself?