> but more importantly, when a person is sick or injured, they usually are not able to comparison shop
You don't need to comparison shop reactively. You can look up some prices preemptively, and choose a preferred hospital that you know to go to when you need it. Obviously not ideal, but it does allow for something.
Also, just having the ability to comparison shop tends to hold down prices, because firms know that you could go elsewhere if they're gouging you and that information tends to escape. It's like how when the wage-fixing cartel among Silicon Valley employers was discovered, everybody at Google got an immediate ~50% pay bump. You didn't need to actively interview at Facebook, because they knew you could and would rather that you not get that idea in your head.
Heck, even post facto, if you're in an emergency and you end up stuck at a hospital that charges $50K for a procedure, and then while recovering you find a nearby hospital that does it for $10K, you're not necessarily without options. It's not hard to go to the provider who actually gave you service and say "You know, they charge 20% what you do... what's the odds I can cause $40K's worth of stink in the local news if you don't cut my price down now?"
(You may want to consult with a lawyer friend a bit before making quite such a naked statement; that may constitute blackmail in your jurisdiction. But there will still be "ways" of phrasing things in your jurisdiction. Talking to a lawyer may not be all bad anyhow, whatever it is you have to say will sound more credible with some lawyer's letterhead on top. Hospitals hear a lot of amateur lawyers expound their novel legal theories every day.)
I'm not going to deny the relationship in that situation is still lopsided in the direction of the first hospital, but the situation is not necessarily 100% in their favor.
A mild correction: it was an effective 10% bump. Google used to have an individual and company multiplier to the bonus which could top out to 25%. The company had repeatedly hit the 25% company multiplier and had strong feedback that the employees preferred predictability in pay. So, they gave a 35% pay raise and phased out the company multiplier.
It also happened in October 2010, which I think was before the wage fixing was discovered (I know the dates because it was after I signed and before I started. Any time I tried to negotiate on salary they countered on stock because they knew salary was going to multiply by a third)
That is not an apples to apples comparison. A gentleman's agreement not to poach engineers with valuable skills is very different from companies charging people with services who are not able to say "no".
There is a massive information asymmetry between health care providers and consumers. Doctors take decades of training. Hell, medical billing by itself is a degree. Consumers will never be prepared to properly assess costs. Even if they could, it doesn't matter when you are hurt and can't refuse.
It's more like food sales at a hockey game. Anyone in the arena that wants to eat or drink has to buy what is being sold. As such, prices are hugely inflated, even though the nearby gas station is much cheaper.
Choosing what you think is generally the cheaper hospital is not a solution. The things they charge you for is varied and you never have a choice as to what they will be. The doctors usually charge you separately, and you can't predict which doctors are on call at any time.
But even more fundamentally, the issue is information asymmetry. Consumers don't have anywhere close to adequate information to make intelligent choices about health care costs. 99% of consumers have no applicable medical training.
The fact that this data has to be published means any one person with medical knowledge and their techie friend can now build a "what's the cheapest hospital near me?" website, which is something we couldn't do yesterday.
This is an enormous problem, and the way you eat an elephant is one bite at a time.
AFAIK you don’t get to choose where you go in case of an ambulance, but if you are taking yourself to urgent or emergency care you can shop around. Heck, I had four torn ligaments this year and at least checked yelp reviews before going to urgent care.
"Ah, yes, I've self-diagnosed myself as having a heart attack. Now, which local hospital had the lowest charge for that? Oh, but what if it needs a bypass operation? That other hospital was cheaper for that..."
The actual thought process during an emergency tends to be more along the lines of "oh fuck it hurts make it stop".
Looking up the prices literally doesn't mean anything. This entire exercise is pointless because it is impossible to tell whether or not you will be charged the in-network fees or price gouged by out of network doctors.
You do some price shopping around and find a hospital that's cheap. It says the hospital is in network, and you go. While you're receiving treatment the hospital has another doctor treat you who happens to be out of network and now all of your shopping is rendered useless as you get slapped with a huge bill.
This is one of many reasons why shopping for healthcare treatment is ultimately useless. What do you do if you go to the hospital and get slapped with treatment that you need, but couldn't shop for until you arrive? What if it's especially critical treatment?
You simply cannot shop around for most medical issues like you can other things because information asymmetry is too high. And putting off a medical issue to do this shopping is frankly horrifying because you have zero clue if the issue you have is critical or not!
If you're experiencing the symptoms of a stroke for example this is an entirely time critical medical emergency. Any second spent not getting treatment reduces your chances of a fuller recovery.
You don't need to comparison shop reactively. You can look up some prices preemptively, and choose a preferred hospital that you know to go to when you need it. Obviously not ideal, but it does allow for something.