People shouldn’t need to shop for health care

Austin Frakt reports on a new NBER study that finds that only one in 100 Americans shop for lower-cost health care, even when it comes to simple elective procedures like MRIs. Rather, they go where their doctors direct them even when they could save money going elsewhere. The study does not consider people’s desire for quality care.

Last September, Kaiser Health News reported on similar findings published in Health Affairs. While comparison shopping could lower your out-of-pocket costs for some tests and procedures, here are six reasons why people should not need to shop for lower-cost health care. Note that people with traditional Medicare do not need to shop for health care to save money; it’s only people with commercial health insurance.

1. First, continuity of care is important for better health, and we should not be moving from one doctor to another based on the cost of a particular treatment.
2. Second, as a general rule, when we visit the doctor, we often receive a battery of services that we could not have predicted. So, even if our doctor charges more than another doctor for the treatment we plan to receive, the other doctor may provide additional services we could not predict that end up costing us more.
3. Third, all doctors and hospitals are not created equal. So, paying less may not mean saving money. And, it could mean getting poorer care. At this juncture, we still have little clue about differences in health care quality among doctors or hospitals. It’s smart to see doctors who come highly recommended, because they have experience and a good reputation for treating people with your condition. Finding these doctors is not always easy, but if you can find them, paying more upfront, could mean paying less later on. (Here are some tips for choosing a doctor.)
4. Fourth, 60 percent of hospital spending is for non-elective services, for which we are unable to shop around, be they emergency services or services in hospital over which we have virtually no control. So comparison shopping is out of the question. We are saddled with bills at whatever level the hospital, in collaboration with our health insurers, is able to set them.
5. Fifth, many people have cognitive impairments and other functional limitations that prevent them from comparison shopping. It’s wrong for our health care system to penalize them.
6. Sixth, most of us are busy working all day, without the time or flexibility to shop around for lower-cost services.

Unlike Medicare, our current commercial health care system permits irrational pricing and price-gouging and offers people very little information to make informed health care choices, even when they have the time and wherewithal to make them.

With improved Medicare for all, we wouldn’t need to worry that our doctors and hospitals were gouging us. Prices would be set, as they are with Medicare. And, in a humane health care system, we all would be able to afford needed care. Traditional Medicare comes closest to that system, though you need supplemental insurance coverage to budget for your care.

Here’s more from Just Care:

• Three reasons why you cannot choose a health plan that’s right for you
• Four things to think about when choosing between traditional Medicare and Medicare Advantage plans
• People with Medicare typically spend over $4,000 a year out of pocket for care
• Why traditional Medicare remains so popular
• Advice A to Z