Pay-What-You-Wish Health Care

Imagine for a minute, just a minute, the chaos that would ensue if health care embraced a pay-what-you-wish payment model (PWYW).  The same model pioneered in (the formerly-antiquated) music industry by the band Radiohead.  Other examples via Freakonomics: law firm, chiropractor, and taxi cab.

What would be most interesting is finding out patients’ perceived value of the services they received.  Health care is an expensive good–and will remain so even after all the waste is eliminated.  But with the majority of payments to providers coming through a mediating party and the majority of payments to the mediating party coming through employers, most people have no concept of the actual cost of care.

“I didn’t feel any better after visiting the emergency room for seven hours,” one patient might say, “here’s $10 for the coffee I drank in the waiting room.”

Or, “Geez Doc, you came in for six minutes and didn’t even touch me during the exam.  Here’s a twenty.”

No more $900 for an MRI, “Thanks for the picture of my knee, $125 should cover that right?  What’s a reading fee?”

A five-day inpatient stay complete with surgery, imaging, and drugs: “$1865.47?”

There would be fewer complaints about Medicare reimbursement.

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