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The doctors of the society, political neophytes all, took out an advertisement in the local newspaper to propose a list of bold cost-saving ideas. They should be music to many patient’s ears.

  1. Price transparency should be mandated: “The difficulty in obtaining the cost or price of medical care should end. These should be very easy to obtain. Doctors are as ignorant as patients as to these prices and hospitals should teach doctors and patients these prices, not hide them.
  2. Not-for-profit hospitals “should be not-for-profit. Period. These organizations currently hide large profits in excessive executive compensation, excessive lavish building projects, bloated foundations, and other ‘shell games.’ … If they invest in fancy new facilities that cannot be financed by more modest charges, they should be allowed to fail.
  3. “Physicians should be prohibited from owning medical care facilities of any nature that they could potentially refer patients to. Examples include surgicenters, laboratories, imaging equipment, etc. This is clearly a conflict of interest and should be illegal.

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For patients who pay cash, a growing number of online pricing tools, such as Healthcare Bluebook, Pratter, ClearHealthCosts, and FAIR Health are available to determine and compare costs for outpatient hospital procedures in your zip code … if you are lucky and live in one of the few states that have managed to create a functional claims database (“All Payer Claims Database” - APCD), you can check online to see what medical providers in your state charged for your needed encounter.

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Reference pricing … leverages contracted insurance plans to prod hospitals or doctors to create well-prices all-inclusive packages for common procedures like joint replacement, cataract surgery, and colonoscopy. … The number of California hospitals charging prices below the CalPERS reference price rose from forty-six in 2011 to seventy-two in 2013.

Appendix D

Tools to help you figure out whether a test or a procedure is really necessary: