In bygone days, when more workers had comprehensive healthcare insurance, the price of medical procedures was not much of an issue. But now, with many people having to make do with high-deductible plans -- if they have insurance at all -- price becomes a huge consideration.
"We are seeing more and more of this, and it's only going to grow over time," said Martin Rosen, executive vice president and co-founder of the Health Advocate, a Philadelphia consulting firm.
The situation has forced many consumers to become comparison shoppers when it comes to medical matters.
"High-deductible health plans encourage consumers to be more informed about healthcare costs," Rosen said. "You are seeing more tools coming out to help them do that."
Not surprisingly, many of those tools are on the Web, and they can be as basic as search engines.
If you type "cost of a colonoscopy" into a Google search, for example, you get some 200,000 matches, including hospitals that offer fixed prices for uninsured patients. There are sites such as PriceDoc.com, MyMedicalCosts.com and HealthCareBlueBook.com that provide information about average prices. Health Care Blue Book also offers links to state agencies that monitor the quality of healthcare.
The state of New Hampshire has gone a step further, offering detailed pricing information online, on a facility-by-facility basis, for both insured and uninsured patients. New York is attempting to do much the same, said Arthur Levin, director of the Center for Medical Consumers, a nonprofit advocacy group. But that state's consumer search engine is not yet fully operational.
Still, it remains a lot tougher to shop for medicine than it is to shop for electronics. Whereas you can do apples-to-apples comparisons from one store to the next when buying a digital camera, few commercial sites offer physician-to-physician pricing based on set procedures. And the handful of sites that do compare physician-to-physician or hospital-to-hospital pricing are usually doing comparisons among only a small group of medical providers.
MyMedicalCosts.com, for example, provides price comparisons among only eight facilities. And you need a lot of medical knowledge to compare prices there. Type in "colonoscopy," for example, and you're given more than two dozen variations of the same procedure. Unless you've got a doctor looking over your shoulder to translate, it's unlikely that you would know which procedure to price.
PriceDoc.com offers clearer information and a larger group of doctors. But the company's president acknowledges that the site has much better market penetration with cosmetic surgeons than it has with doctors who do nonelective medical procedures, such as hip replacements.
"If you're looking for an endocrinologist, we don't have it," said Patrick Bradley, PriceDoc.com's president and chief operating officer. "But if you want to get your teeth whitened or get a tummy tuck, we have a number of physicians to choose from in most major metropolitan areas."
There are roughly 800,000 medical offices in the country, Bradley said, and PriceDoc represents about 4,000 of them. The company recently signed a deal that could bring thousands more doctors into the fold, but the site is still likely to be stronger on elective procedures than necessary ones.
Realistically, Bradley said, the nature of medicine makes it tough to compare prices. Individual factors such as health history, family history and age vary so much from patient to patient that a site couldn't guarantee a price to treat conditions such as diabetes. One patient might need a lot of intensive medical help, whereas another might require only occasional visits to the doctor.
By the same token, the ability to compare costs for more price-predictable procedures -- such as colonoscopies, mammograms and teeth cleanings -- is getting better by the day, Bradley said. "I think it's the wave of the future."
Kathy Kristof writes for the Los Angeles Times.