I want to take a moment to share some observations and do a bit of editorializing this episode.

And the topic I am going to discuss today, I am going to title the health care consumer in a fictitious market.

I think we can agree and that we can't ignore that most Americans actually do like systems and routines.

Chains like Starbucks have thrived, charging significant sums to fatigued consumers willing to shell out time and money for a luxury.

We are living in an era where checks and balances to prevent mistakes and to decrease

variation in latte preparation has become a modern reality. Whether we go to a Starbucks in

Kara Springs or Chicago, we get remarkably similar experience. So why can't health care have similarly happy customers and consistent outcomes?

And there are a few reasons for that. First of all, we understand what we are paying for in nearly

every business transaction except for health care. At this point, just about everyone understands that health care reimbursement is

extremely complex. Now, when I receive bills from a doctor or hospital, I get confused. And I

understand the system better than 99% of the public. For a colonoscopy that I needed a few years

ago, I paid a copay, then a facility fee,

then received bills from the gastroenterologist, the anesthesiologist, the pathologist, and some other

fees I still don't understand. The bills arrived separately over a couple months. There was

zero transparency about the charges before the procedure.

It is one of the many reasons why several advocate for a single bundled case rate

that consumers will be informed of before an elective procedure.

Because huge price variability exists across most geographic regions for the exact same

medical procedure. There is no evidence that those charging more have better quality or outcomes.

See, coffee drinkers would quickly figure out if a nearby shop charged triple the amount of a competitor. It is not so easy

to figure that out as a patient. Most hospitals and doctors aren't even aware of what competitors

charge. Pointing out existing price variability is not an accusation of swindling, but rather

...