Blog by Sumana Harihareswara, Changeset founder

17 Oct 2007, 13:12 p.m.

Clarity in Pricing Is Respectful, Not Sordid

Hi, reader. I wrote this in 2007 and it's now more than five years old. So it may be very out of date; the world, and I, have changed a lot since I wrote it! I'm keeping this up for historical archive purposes, but the me of today may 100% disagree with what I said then. I rarely edit posts after publishing them, but if I do, I usually leave a note in italics to mark the edit and the reason. If this post is particularly offensive or breaches someone's privacy, please contact me.

Jay Parkinson, the new Brooklyn doctor who does house calls, instant messenger, and email, has now been practicing for a few weeks. I'm hoping that Parkinson's example, like that of quick clinics (link to my January rant), helps add healthy competition into a really freaky economic situation.

Markets work when sellers compete and when buyers and sellers have good information about the choices they make. But when was the last time you saw a simple price list posted at a doctor's office, the way there is at a body shop? One interesting moment:

I saw a patient the other day who needed an inhaled steroid (no generic available) that the local big chain pharmacy here in NYC sells for $130. My database says there is a mom and pop pharmacy in the Lower East Side that sells it for $85. I called the pharmacy and told them their "drug retail price list" says they offer it for $85 and I have a cash-paying patient who needs this drug. The pharmacist was quite surprised. "How did you get this and who gave it to you?"...

Wouldn't it be nice to be able to do a Google search for the actual price of a mammogram (the price range here in NYC is $125 to $750) at any facility in the country for a cash-paying customer?... At present, there is absolutely no way to search these prices short of calling hundreds of facilities to find the best price. Trust me, I've done it. It's hard work trying to uproot an entire industry's concerted effort to keep you in the dark.

The profits in the healthcare industry depend upon their customers' ignorance of the actual cost of medical goods and services and the data behind why you actually need these goods and services.


17 Oct 2007, 16:37 p.m.

At present, there is absolutely no way to search these prices short of calling hundreds of facilities to find the best price.

I smell a business model.

Also, randomly, about economics, now there's Masonomics. We are all Masonomists... in 2050!

Joseph Walch
17 Oct 2007, 17:29 p.m.

All very true. I am highly in favor of Nurse Practitioners and those CVS clinics. I imagine it is scary for patients to have a doctor order an expensive test. Often, the doctor doesn't even know what it will cost for the patient (since often it is different for each patient). It isn't easy to price discriminate if everybody knows what other people are paying for a certain good or service, though.