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You don't know in advance of the visit, but you know before you take other actions. At that point, inform your patient.
This is definitely a lie.
The prices have no relationship with what the patient pays. Why do you not understand this? What is so hard to understand about that?
That is exactly the problem, though. If healthcare is going to be a paid service provided by the market, pricing for the end user should be clear and telegraphed. If it’s going to be some kind of nebulously complex system where many people pay different things for the same product, then we may as well just have single payer, if only for clarity’s sake.
I don't in principle have any issue with modifying our system to more resemble a market, I suspect that would potentially have efficiency gains but may not be feasible given the amount of money involved and the inherent variability issues (as previously mentioned 5k for a surgery is a reasonable amount for someone to self-insure and so on, millions of dollars thought?). Also a million other questions would need to be answered (do we keep having healthy young people subsidize the sick?).
As is the prices have nothing to do with the patient the price is whatever their insurance's rules are (premiums, copays and so on).
Any information released by the hospital is unrelated to the patient's experience. A cheaper list price may be cost the patient 50,000 dollars, a more expensive list price may be literally free (if that's the way the coverage breaks down).
You can squint and try and figure out places where price transparency might help. I may see that my competitor across the river offers the same surgery for 500 dollars less and go "ooh wait maybe I could be saving money here" but when you shake those out practically they don't work out. Maybe the cost savings are because they average out their anesthetic gas charges over all procedures, they have more volume, or the people on my side of the river are fatter so cases take longer.
If you've got one I'll listen though.
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I'll take your silence to be an admission that you can inform your patient before you take other actions.
You can provide your patient the information that you have, as we have discussed over and over again.
See above.
I didn't answer your other statement because it was incorrect and misunderstands how this works.
We have already agreed that you have pieces of information that can be useful. It was very long ago at this point. Just give them the information that you have.
On the other bit, you're going to have to give me a reason why you can't inform your patient before you take other actions, because so far, a lot of your stated reasons for things have been somewhere between bizarre and bollocks, so I'm definitely not going to accept a completely unstated reason.
I said the price of apples has value.
The prices of oranges has no value, especially when you are actually buying whole wheat pasta.
You want me to hire an orange consultant to teach someone about oranges but we are giving them pasta.
Hiring an orange consultant isn't free, and will lead to people being confused when they end up eating sauceless pasta instead of an orange.
You don't need to hire a consultant to inform your patient about the charge that you will be billing their insurance or the negotiated rate. Apples/oranges/whole wheat pasta is another bizarre thing that appears to have no relevance to the question at hand. You have the information we've been talking about. You can just inform your patient. You can do it before you take further action that would generate such a charge. It would be unethical to do otherwise.
The information a patient needs to make a decision is whole wheat pasta, but you are demanding that I give them information about oranges.
This is the problem.
Patients want to know what they will pay. This is whole wheat pasta. Insurance is in charge of whole wheat pasta. Whole wheat pasta is what the patient gets.
Oranges are what you are asking for. Oranges have little relationship with whole wheat pasta other than they are food. What the insurance company does to turn oranges into whole wheat pasta is mostly nonsense and depending on the thing may be literally 100% unrelated. Knowing about oranges tells you little to nothing about whole wheat pasta.
For this reason oranges are not my job. I do know about some oranges, there are other oranges I know nothing about, because oranges are never relevant to the patient.
Informed consent implies information, information about oranges does not enhance knowledge of whole wheat pasta. Patients are getting whole wheat pasta, not oranges.
Furthermore, gathering information about oranges (which are not whole wheat pasta) is not free. You are asking me to spend time and money on oranges while the patient is getting whole wheat pasta.
This would have the impact of increasing the price of whole wheat pasta without improving its quality. The patient would still not get oranges.
Now the patient is confused! Why did you tell me about oranges? I got whole wheat pasta instead.
Because some random person on the internet insisted I tell you about oranges despite the fact that you were getting whole wheat pasta.
You're ignoring what I've written time and time again. I am asking you to simply inform your patient about the charge you are going to submit to their insurance and the negotiated rate. That is information that can be useful. You are correct that it is not an exact description of exactly what they will pay out of pocket. There are also deductibles, co-insurance, out-of-pocket max, etc. That's not to do with you; that's why you're not telling them those other things. You're telling them the information that you have - the charge that you are going to submit to their insurance and the negotiated rate. You have this information. You can tell them. Just tell them.
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