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You have made this accusation multiple times, I have consistently maintained that it is fundamentally unknowable (because it is) if you loosen your definitions of knowable you can know some things about it. Additionally, it ultimately is not relevant and not our job, but we do know some things about it anyway.
If you think you "got me" in some way you will need to clarify.
This tack is not helpful, unlike last time I've tried to give examples of things you don't know and would need to know in order to understand the complexity at hand, but you need to actually engage with them. Every example I've given you about how healthcare is not like a car repair shop has been ignored.
Can you remember what your answer was two days ago?
Yes. Please see above. Thank you.
If you had a lottery-type game as an option that you could consider playing, and they said, "The payout is $5k with about probability p, and the payout is $1.5M with probability 1-p," would you say that the payout is "fundamentally unknowable"?
Yes.
Expected payout does not equal pay out.
In car repair your estimate may be off by a few hundred to a few thousand dollars. Maybe more than a few thousand dollars at maximum.
In healthcare your estimate can be off by hundreds of thousands of dollars or more.
This impacts the wisdom of giving estimates and the validity of the practical validity of those estimates.
And AGAIN you have yet to establish why cost matters. As previously stated repeatedly healthcare workers are often prohibited by law from making decisions based off of cost and often by necessary convention when not prohibited by law. Patients almost never pay cost and are rarely charged it. Why does it matter?
Engage with the substantive and relevant portions of the discussion.
I'm not sure we can proceed much further. You have a highly unorthodox definition of "fundamentally unknowable". You seem to apply it to a thing that I view as incredibly knowable. Perhaps we just have different levels of background in probability and decision theory. Perhaps I should wave my degrees and/or publications around (they do happen to be highly relevant) and say that if you can't answer highly technical questions about probability and decision theory, you don't know anything about what you're talking about? How should I think about how you might feel about that form of argumentation?
We're talking about patient decisions.
This is obviously not true, as evidenced by the constant uproar about medical billing. To repeat myself:
The old saying just happened to pop up in my mind: "The first step is admitting that you have a problem." I'm not quite sure what else it will take for you to realize that your industry has a problem. I hope it's not more assassinations or slap-dash regulations.
What information do you deliver to the patient. The maximum? The median? The average?
These are all wildly different, would potentially impact patient decisions, and do not matter because the patient isn't paying it.
What, if anything, a patient gets stuck paying after insurance has nothing to do with the cost or the charge.
You're forgetting your own answer again. You gave a perfectly fine answer. It contains the information that you know. You know that it typically costs about $5k, but about 1% of the time, it costs $1.5M. You know this. You "plan around" this. You just choose to not let your patient know anything about the costs part of your plan. You choose to keep your patient in the dark. You choose not to inform your patient.
Look, we know that you don't know everything with deterministic precision. That's fine. We also know there's a knowledge gap between you and the patient, both in terms of medical costs/benefits and in terms of financial costs/benefits. You understand that part of your job is to at least try to inform your patient, to the extent you can, about the medical costs/benefits, as you understand them. This will not always be perfect. Moreover, there will be unknown unknowns. Some might even say that some of the medical costs/benefits are "fundamentally unknowable". But you don't just throw up your hands and say, "Therefore, we never bother informing the patient at all." It's that your story changes 180 degrees when it comes to the financial side. You don't even try.
"The first step is admitting that you have a problem." Please please please don't let it take more assassinations or new slapdash regulations before you get this.
I mean patients ask sometime. We answer. Depending on the thing I can give hard numbers and explain that would be misleading, depending on the thing I cannot.
Ultimately it doesn't matter. What the thing costs, what the mark-up is, what the charge is, what the insurance pays, and what the patient ultimately pay are all different numbers.
You have to yet to explain what the relevance and importance of this number is, despite me repeatedly asking.
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