Last year, my daughter caught a stomach bug and for a few days woke up each morning nauseous. We took her to her pediatrician and were surprised to find out that "waking up nauseous" is a Big Deal; it can be a neurological symptom. We were pretty sure that wasn't it (there were... other symptoms... corroborating our "stomach bug" hypothesis) but the doctor was adamant: if she kept waking up and puking, she'd need to get imaged.
She got better and we cleared her to go on vacation with her grandparents, and were just about to get on a plane to go give a talk at Black Hat, when we got a call from our parents in Michigan telling us she was puking again. We called the doctor, who demanded we retrieve her and scheduled a CAT scan.
We are at this point freaked out for a variety of reasons, some of them logistical (trip to conference, driving back/forth to Michigan, &c) but also from the fact that our doctor knew what an epic inconvenience all was and was absolutely clear "daughter needs CAT scan" --- so in the back of our heads there's gnawing "something could really be wrong" (Adia had seizures when she was 4, which, by the way, GUESS WHAT DING DING DING UNINSURABLE ON PRIVATE MARKET NOW, and now 7 years later I still can't even hear she has a headache without taking an inventory of all other possible symptoms.)
So anyways, we want that CAT scan done now now now yesterday now. We get to the hospital for our appointment and: problem with our insurance card. No big deal, we'll just resched--- fuck that, I'm paying cash.
Head scratching ensues, long story short, very large hospital in Chicago doesn't have any price list for a CAT scan at all. Not even an insurance cost to pass on to me, let alone a cash-basis discounted price. Getting imaging done at a top hospital in Chicago without insurance: unheard of. They ended up just making up a price on the spot; $1000.
I have on a few occasions floated the idea of making it illegal to insure more than 90% (say) of procedure costs -- there would always be a mandatory 10% copayment. No one I mentioned this to ever seemed to understand the point. I don't know that the proposal is actually workable, but I think you can see where I'm coming from. If patients had to know all the prices because they had to pay some fraction of them, the whole system would look very different.
Making up prices is routine. Got my wisdom teeth extracted. They said there would be a $170 X-ray fee. I already had X-rays done from my regular dentist and brought those in. During the checkout they scratched the $170 X-ray fee and then added at the bottom a $170 consultation fee. I thought pissing off people who are about to knock me out and operate on me is probably not a good idea and didn't say anything.
She got better and we cleared her to go on vacation with her grandparents, and were just about to get on a plane to go give a talk at Black Hat, when we got a call from our parents in Michigan telling us she was puking again. We called the doctor, who demanded we retrieve her and scheduled a CAT scan.
We are at this point freaked out for a variety of reasons, some of them logistical (trip to conference, driving back/forth to Michigan, &c) but also from the fact that our doctor knew what an epic inconvenience all was and was absolutely clear "daughter needs CAT scan" --- so in the back of our heads there's gnawing "something could really be wrong" (Adia had seizures when she was 4, which, by the way, GUESS WHAT DING DING DING UNINSURABLE ON PRIVATE MARKET NOW, and now 7 years later I still can't even hear she has a headache without taking an inventory of all other possible symptoms.)
So anyways, we want that CAT scan done now now now yesterday now. We get to the hospital for our appointment and: problem with our insurance card. No big deal, we'll just resched--- fuck that, I'm paying cash.
Head scratching ensues, long story short, very large hospital in Chicago doesn't have any price list for a CAT scan at all. Not even an insurance cost to pass on to me, let alone a cash-basis discounted price. Getting imaging done at a top hospital in Chicago without insurance: unheard of. They ended up just making up a price on the spot; $1000.