1. Nobody knows the fair and accurate price for anything. So called transparency is therefore irrelevant
2. Every payer from Medicare to Medicaid to private insurance to individuals pays something different
3. The private sector is subsidizing the public sector
Let’s start by having one price paid by all payers.
Look at these bills I just received. The first bill is for four hours in an emergency room. Note the price of one MRI.
More important, look at “adjustments.” Of the $20,183 bill $18,455.70 was not allowed by Medicare. Had this claim not been Medicare, that disallowed amount would be far less. The poor person without insurance would be billed $20,183.
The following is a bill to transport patient (my wife) from first to another hospital about 40 minutes away. Again, most of the charge is ignored. In both cases I must pay the balance because my supplemental coverage does not kick in until I have paid $1,000 out-of-pocket in addition to my deductible.