X-ray showing a new artificial hip. No, I don't know how much the patient paid for it. (okadots/Flickr)
X-ray showing a new artificial hip. No, I don’t know how much the patient paid for it. (okadots/Flickr)

If you want to buy a new car, you can probably figure out a price range within a matter of minutes with a google search. The same is true for many other products. But in health care, forget it.

In a new study published today in JAMA Internal Medicine, researchers called more than 100 hospitals across the country. They included a range of both top-ranked centers and community hospitals and inquired about a common elective surgical procedure — a hip replacement — for a fictitious 62-year-old grandmother.

First off, only 10 percent of the non-top-ranked hospitals and 45 percent of the top-ranked hospitals were even able to provide a price. Researchers were a bit more successful when they called the hospital and physician separately.

And just what was the price range? $11,100 on the low end to $125,000 on the high end.

“Patients seeking elective (hip replacement) may find considerable price savings through comparison shopping,” the authors write. No kidding — except that half of the institutions couldn’t even provide a price.

Americans hear over and over that they must be better consumers of health care, but it’s pretty tough when information can be so hard to get or difficult to interpret. Maybe you can get crash data on that new car you want to buy, but it can be tougher to get information about quality for a health care procedure than it is to get a price.

“Without quality data to accompany price data, physicians, consumers, and other health care decision makers have no idea if a lower price represents shoddy quality or if it constitutes good value,” say medical ethicist Ezekiel Emanuel and Andrew Steinmetz in an accompanying commentary they co-wrote. “And, since patients are reluctant to cut corners when it comes to their health and the health of their family members, they are liable to falsely assume — as they do in other markets — that higher prices correlate with higher quality.”

Emanuel opens his commentary with a brief history of trying to buy a car in the 1950s, how buyers were completely at the mercy of dealers, that little quality data was available. It took an act of Congress in 1958 to force car dealers to display the now-ubiquitous MSRP to the window of every new car for sale.

“The history of the automobile industry shows that information asymmetry is treatable,” Ezekial and Steinmetz conclude. “Health care will need to travel down a similar path. It is time we stop forcing people to buy health care services blindfolded — and then blame them for not seeing.”

We’re still in the infancy of transparency of cost and quality information. Sites like ClearHealthCosts have pricing information on a number of common procedures. CalPERS — the California Public Employees Retirement System — looked at its own claims for knee and hip replacement. It, too, found a range of $15,000 to $110,000. In 2011 CalPERS set a threshhold price of $30,000 for a hip or knee replacement. A CalPERS spokesperson says they made sure its approved facilities met a quality standard.

We have a long way to go. In the meantime, caveat emptor.

How Much for A Hip Replacement? Good Luck Trying to Find Out 8 May,2013Lisa Aliferis

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  • dofaust

    If you live on the West Coast, RUN, don’t walk to UCSF, always the top-rated in almost all specialties that require serious surgeries. They often COLLABORATE with Johns Hopkins, who also is the top three rated specialties – as determined by their PEERS.

    AT ALL COSTS AVOID STANFORD, who now is rathed consistenly TWENTIETH or lower. THAT IS A HUGE DIFFERENCE IN QUALITY. DO NOT EVEN GIVE STANFORD OR UCLA A CHANCE, GO DIRECTLY TO UCSF, even if you must wait a few months for full intake….and….they accept ALL, repeat ALL forms of insurance, and because of their status as one of the BEST RESEARCH HOSPITALS, have different sources of funding, that allow them to make financial arrangements with patients THAT NO OTHER PROVIDER WANTS TO DO. Our family has had two successful very signicant surgeries at UCSF – after wasting YEARS talking to minor-league surgeons. You may my write me privately at dofaust@gamail.com, or gogle for “dofaust” to find me, for even more horror stories, if one goes elsewhere.

    Also, in California YOU CAN’T AFFORD A MISTAKE,

    since the statute of limitations for malpractice is TWO YEARS and the award limit is $250K. Its laughable. Thank that wonderful conservative political party, and the AMA.


Lisa Aliferis

Lisa Aliferis is the founding editor of KQED’s State of Health blog. Since 2011, she’s been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including Dateline NBC and San Francisco’s CBS affiliate, KPIX-TV. She also wrote up a handy guide to the Affordable Care Act, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for “Best Topical Reporting” from the Online News Association. You can follow her on Twitter: @laliferis

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