I always get a kick out of the process of formulating a price for surgical services.  Many times physicians have no idea what a fair price is for their professional fees!  The fees at our surgery center are a function of time and materials.  Operating room time is expensive and the supplies that are needed for completion of a surgery are expensive and have to be accounted for.  The anesthesia fees are with rare exception a function of time and are not particularly difficult to come up with.  I have done this for years as we have taken care of uninsured patients since 1997 that wanted to know “how much will it cost…total?”  That this transparency is absent in medicine is a huge problem.  Imagine not knowing the cost of a single item at the check out stand at a grocery store but once you are in line you are committed to buying everything in the cart, regardless of price.

I don’t think that we will see transparent pricing from most medical facilities any time soon.  There is too much money to be made from the unsuspecting medical consumer at this time.  But as Thomas Sowell has pointed out, the right question to ask in any economic situation is “compared to what?”  Sowell has joked that when an economist was asked how his wife was, he said, “compared to what?”  I think his point is that you can’t properly evaluate any price or economic system by itself..you always have to evaluate it in comparison to some other price or system. The Austrian economists would say, I think, that any anticipated expenditure is naturally compared to the next best alternative (my apologies to the Austrians reading this if this isn’t exactly right).  Some people might say that $2860 is too much to pay for an inguinal hernia repair (our price online).  Sowell would say…”compared to what?”  We have had patients come to our center from Alaska that were told that their hernia repair would cost them $20,000 up front with unknown costs coming after the procedure!  For those Alaskans our prices were low compared to what they were facing in their home towns.  Our prices have been on line now for over 2 years.  We have been the answer to Sowell’s question many times for many patients.

G. Keith Smith, M.D.