Consumer engagement in healthcare is harder than it seems

Every time I hear a story about consumer empowerment in healthcare, I get optimistic that consumers really can make a difference in containing runaway healthcare costs. Then something comes along to make me think that it’s a pipe dream. I just had one such occurrence.

Trending on Twitter right now is the meme “#pricesthatshockyou.” Just for fun, I clicked. Right near the top I saw this:

Honestly, i don't know why the american gov't makes the people pay so much for medical bills. Its not always their fault #pricesthatshockyou

Uh, the American government doesn’t set the prices. Sure, CMS sets Medicare reimbursement rates that often serve as a model for other payers, but providers set the rates they charge. Whether you have insurance or not, the government doesn’t have much say at all on the list price for medical services. (Yes, regulation adds to costs, and Medicare sets the tone for the fee-for-service model that has resulted in ridiculous utilization patterns, duplication and the like, but I really don’t think we’re dealing with an actuary or healthcare finance professional in this particular tweet. This is an average citizen with no concept of how the system really works.)

The sad thing is, it’s been retweeted at least 10 times.