Haggling over price with your doctor

David Cay Johnston in Newsweek explores the myth that healthcare is and should be a free market. The article was prompted by calls that healthcare's ills will be eliminated by a free and fair market.

More than four decades ago the Supremes defined a fair market as the

price at which the property would change hands between a willing buyer and a willing seller, neither being under any compulsion to buy or to sell and both having reasonable knowledge of relevant facts.

If these things don't exist price gouging happens.

So let's explore the details.
Price:
* Do we know the relevant data to check the price of an MRI or a dozen stitches?
* Price seems to be confidential and none of the patient's business until the bill is sent.
* Haggling with the doctor about price makes as much sense as haggling with an airline pilot.

Reasonable knowledge of relevant facts:
* What procedures and medications are essential to treatment?
* Is the treatment even necessary?
* What are the alternatives and their cost? Which one is best?

Free of Compulsion:
* Is that possible after an accident when you're writhing in pain and bleeding profusely?

If there is a free market there would be a narrow range of price for the same service. But prices for medical procedures vary widely. In addition the prices in America are much above the rest of the world. For example, the average cost for a day in the hospital is $853 in France and $4287 in America.

Johnston's proposal: Medicare for all. Switching everyone to Medicare would save enough money to flip the federal budget to surplus.