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This works for a basic "checkup" type thing which is bounded, but in a "cut you open" situation, the higher end of the spectrum is "your vitals suddenly collapse and you have to be taken to the ICU for a week, that will be $300K". Nearly every surgery would have to have this as one of the possibilities.
Moreover, that's not one a patient could be realistically given an opt-out from -- they can't just leave you to die.
Absolutely correct. The correct lens to look at this through is informed consent. Patients must be reasonably informed of the known costs/risks/benefits of medical procedures at the point when they give consent. Prices are part of costs, so they need to be reasonably informed of them when they give consent.
Of course, when they're lights out and cut open and something happens, there is no opportunity to inform them of the medical costs/risks/benefits, so we reasonably say that in such situations, it is acceptable to proceed anyway. All you need to do is import the exact same considerations to the question of when you can skip informing them of pricing information. If you feel ethically comfortable not getting informed consent for the medical costs/risks/benefits, sure, go ahead. Otherwise, when you're informing them to a reasonable extent about the medical costs/risks/benefits, you also need to inform them to a reasonable extent about prices. Just tell them what you're planning and what you know about that plan.
Oh definitely. I think that's fine.
I think the other bit is that up-front, the estimate for any surgery with anesthesia is going to be "it's unlikely but as we discussed there are risks in anesthesia and so in the worst case you nearly die and it's gonna be $300K".
Sounds fine to me! Maybe not even strictly necessary to put numbers to all the things. Again, it's just informed consent, just like medical costs/risks/benefits. You can say that there are risks in anesthesia, that unknown complications can happen, and if they do, you'll do what you can (where the actions and price are yet unknown). However, in some cases, where it's a "routine" complication, you can advise a little better. One doctor in these forums suggested that there are some procedures where they know that something happens about 1% of the time, that they plan for it, that they know what they're going to do if that happens (e.g., "If we see X, we're going to remove Y also"). In those cases where you have reasonably known specifics with reasonably known, planned actions, what you do is inform the patient. You can likewise inform them with reasonable information about likely costs of that relatively-known event and following actions. I think people would be perfectly happy with that.
All of this is getting into what is a common situation in hospitals, but is relatively rare for individual patients and in terms of total patient interactions with medical billing. It's kind of an edge case, though it is important to put some thought into. I think people would be pretty fine with a variety of practices concerning informed consent in these edge cases if the industry started getting the basics done on the much more vast world of much more numerous, much simpler services.
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