Healthcare Is Expensive, So Why Don’t We Comparison Shop?

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by Ed Tobias |

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shopping, cost, healthcare

If you’re going to buy a car, do you limit your shopping to just one car dealer? If you need gas, do you drive past three inexpensive service stations because someone told you to fill up at a fourth, where the price is much higher? I don’t think so. But that’s what a lot of us do when we need to “buy” some healthcare services.

That’s the conclusion of a working paper that the National Bureau of Economic Research just published. In this study, written by healthcare, economic, and management experts at Harvard, Yale, and Columbia universities, patients had the opportunity to use a price comparison tool to research the cost of a non-emergency MRI. Fewer than 1 percent of those patients used it. The study also shows that a patient who needs to get that MRI will, on average, bypass six lower-priced providers on the route between their home and the location where they receive the scan. Had the lowest cost MRI provider been selected, the study reports, the patients could have reduced their out-of-pocket costs by about 30 percent and saved their insurance company about 40 percent.

Why aren’t patients comparison shopping?

Why do we select a particular facility if we need a non-emergency test, such as an MRI? The answer is we usually don’t select it — our doctor does.

“Ultimately,” the study reports, “we find that [the] referring physician is the strongest determinant of the cost of the MRI scans patients receive.” It continues: “… As a result, we find that in order to attend a cheaper MRI provider and save money, patients need to be diverted from their physicians’ pre-established referral pathways.”

Is healthcare shoppable?

“Our evidence suggests that, at present, the answer is ‘no,'” authors Michael Chernew, Zack Cooper, Eugene Larsen-Hallock, and Fiona Scott Morton concluded. “Going forward, our findings suggest that because of the weight patients appear to place on the advice of their referring physicians, it is unlikely that a significant number of patients will use information from an app or from a pricing webpage, or to diverge from where their physicians typically send patients for imaging studies.”
I’d like to think that the conclusion by the study’s authors is a little too pessimistic. If patients realized they have the ability to comparison shop, and if doctors were proactive and told their patients that it’s OK to shop around to save some cash, I think more of us would do that.
What do you think?

(By the way, if you need help paying out-of-pocket costs for an MRI, the Multiple Sclerosis Association of America recently expanded its MRI assistance program. Find the details in a column that I wrote back in June.)

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.


Desiree Zerebnick avatar

Desiree Zerebnick

I know that not all MRI facilities are not the same. beside the cost...we must ask what type of MRIs.are available. Also...INSURANCE FICTATES where me must is TERRIBLY UNFORTUNATE.

me avatar


I tried to comparison shop 10mg/10mL vials of cladribine to treat my MS. Insurance wasn't covering. No speciality pharmacy would just give me a price. System is opaque. I spent hours on the phone, finally got a price of about $450 per vial. For the next year's doses, called back and they said $1500 per vial at first. When I said WTF!!, they gave me the previous price. In a transparent market, price should be less than $100 per. Give it a try yourself, it should make an interesting column. I doubt that you could even price comparison shop something like having a baby delivered or an emergency room visit.

Ed Tobias avatar

Ed Tobias

Thanks for sharing that experience. It's certainly not easy to get these costs but we certainly should try, as you did.


Agnes Weessies avatar

Agnes Weessies

A new twist on cost. You may pay up front the total you are told you owe at time of service, but that's only part of it. Now many are separating facility fees and charging after the fact to generate more income. So now we pay the Dr./hospitals overhead as an add on no matter if Insurance and you are under the impression that at time of service covers it all. My son with MS and myself with bad back have had this open to both of receiving MRI's. No transparency or disclosure up front of the real and full cost!

Ed Tobias avatar

Ed Tobias


Thanks for sharing this info. It seems as if we all should be asking about this before we make a appointment so that we can decide whether to proceed or to look elsewhere for a test or a treatment.




Ed. Please take a look at this health care reform plan that leverages the power of consumers in a partial health care free market. Your feedback would be appreciated.

This plan would seek to restructure healthcare into a 50% free market + 50% high deductible single payer plan. thanks

Ed Tobias avatar

Ed Tobias

Thanks for sharing.

I'll have a look but it may take a few days for me to get to it. I'm just back from a trip and I'm catching up on a lot of things.



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