How much is a hip replacement in a US hospital?

When researchers asked 102 US hospitals how much they would charge for a total hip arthroplasty, just 10 were able to give a single price for a standard procedure. Another 54 provided separate prices for the hospital’s fee and doctors’ fees, but only after separate telephone calls to hospital administrators and doctors’ offices.

A different sample of 20 top ranked orthopaedic hospitals did better—nine provided a bundled price and another three managed separate hospital fees and doctors’ fees. The researchers had to make multiple phone calls to get even this limited information from each hospital. They used a standard script explaining that the patient, a 62 year woman, was uninsured but had the means to pay.

Between 30 million and 50 million people in the US have no health insurance, and many others have benefit packages that don’t cover the full cost of treatments. Both groups need accurate and easily accessible pricing information if they are to make economically rational decisions about where to go for treatment, say the authors. The price of a total hip arthroplasty varied more than 10-fold in this study ($11 100 (£7040; €8300) to $125 798). It therefore pays to shop around, so long as price doesn’t equate to quality.

The current lack of transparency resembles the early days of the car industry when purchasers had no idea how much they would have to pay, or what they were paying for, until they were fully committed, says a linked comment (doi:10.1001/jamainternmed.2013.465). The result was a broken industry, which was eventually fixed by legislation that forced dealers to disclose pricing information. Policy makers are pushing for transparency in healthcare pricing too, but progress is slow and prices aren’t much use without accompanying data on quality. It is time we stopped forcing people to buy healthcare services blindfolded and then blaming them for not seeing, write the commentators.