I have to admit I was against ACA for a variety of reasons, but if the first step is increased price transparency and exposing that data, it will do a lot of good.<p>The best reform I can think of would be a combination of individually purchased (vs. employer) HSAs, where poor people get grants of up to the the full deductible per year in some kind of special account IFF they sign up for HSAs, and price transparency. Employers who currency pay for your entire insurance could give you an equivalent amount (plus deductible) which goes into your Health Savings Account.<p>You're then effectively paying an army of 300 million to constantly search for the best prices (or rather, to find third party organizations to search for the best prices for them). $3-5k/person is actually not <i>that</i> unreasonable for the poorest 30mm people and those covered by medicare/va/medicare-for-kids/etc.<p>I'm confident this could drop the prices of procedures by >10x, comparable to other countries. Americans are really good at driving down costs <i>when they know the costs and are paying them out of pocket</i>; look at how much cheaper it is to buy an iPhone in the USA vs. where it's made.
This is why the ACA is such a boon for people that thonk health care should be a free market. It takes the free market ideals and embraces them; the accusations of socialism are more telling of the accuser than the accused. That's not to say that I think health care should be a free market, just that its the goal of the ACA, and the current situation in the US is much less free a market, and due to employer provided insurance, barely a market at all. No price information is communicated to consumers, and the ACA will start to do that.
I do not understand why there is no public list online with the basic costs of operations (including all the variables). With price transparency a lot of this unequal treatment and prices would surface. I understand there are a lot of variables, but not like it wouldn't be possible. (I understand a treatment at Hopkins would be more expensive than say at your local hospital, but at the very least it would be clear how much more expensive it actually is.<p>EDIT: One way to do it nationwide would be to ask people to send in their bills (anonymized).
I wonder, since we strangely expect employers to provide healthcare insurance in the US, what if employers just decided to provided actual healthcare.<p>Imagine taking all of the health premiums Google pays for its employees, and instead of feeding it in to a broken system, you build a world class health facility in Mountain View that's free to employees.
Always tell them you are paying in cash.<p>Take bill home and sumbit to insurance if you are lucky enough to have insurance.<p>You just saved the system at least 75% of the cost.
So great I now know that hospitals charge different fees which is still pointless since my federally mandated heath insurance will pay either one of those prices at no difference in cost to me. In reality I can get my hip replaced at any institution and pay nothing more then the $300 a month I pay for my health insurance. So in the real world the price of all those procedures _to me_ is $300 a month.<p>This is not a free market. Making these prices public isn't going to make it a free market. No problems have been fixed. Only new and novel problems have been introduced.
The table this is based on uploaded to fusion tables.<p><a href="https://www.google.com/fusiontables/DataSource?docid=1VlO_qd-JvxWE_HF7jFDyScvpMQV0AZArZL4y1us" rel="nofollow">https://www.google.com/fusiontables/DataSource?docid=1VlO_qd...</a>