"Perhaps a truer pricing disclosure would be posting what hospitals receive in actual “average” reimbursement for most common procedures from all payers for the last 12 mos."

I like this idea! I would suggest clearly defining the formula and breaking this out between Medicare, Medicaid and Commercial payers.

This is Deja vu indeed! Back in 1984, as a newly minted health economist, my first foray into public policy was making a case for more info on hospital pricing as one strategy for instilling more competition. Then Assembly Health Committee Chair Curtis Tucker introduced a bill within a month of floating the idea with chief consultant Paul Press. The bill required hospitals to post in publicly accessible areas their “charges” for common procedures. We now refer to such policy as advocating transparency in pricing. It drew immediate/predictable opposition from the hospital industry; this was leverage Tucker wanted to horse-trade for another policy/bill. Fast forward some 20 years; we are still trying to make sense of arcane hospital accounting systems based on charges that have no relevance to real market dynamics. Perhaps a truer pricing disclosure would be posting what hospitals receive in actual “average” reimbursement for most common procedures from all payers for the last 12 mos.

The system is stacked against transparency. If you are involved in a fender-bender paramedics at the scene will urge you to go to the E.D. even if you feel fine. But ask what it will cost and they shrug. The cost could be as much as $15,000--merely to tell you what you think you already know--you're fine! But because you're insured, you shouldn't care it costs, right? In reality, you have no way of making a sensible choice and thus, you are part of the problem of persistent high costs. It's ridiculous that we can't know in advance what a hip replacement or other joint repair will cost. It's ridiculous that physicians write prescriptions for drugs that cost $400, when there's a slightly less potent over-the-counter drug for $25 that would do the trick. And if we don't fix it, we're going to bankrupt our children.