>This feels pretty weak. You can't afford to take a day off work, but you can afford to pay an extra $40,000? Basically nobody is in that situation. If they incur the $40,000 debt, they'll not be paying it, so this is really just your second group.

This reveals that you have an utterly fundamental misunderstanding of how things work in the US but I'll give it a shot at fixing the problem. For many people an extra X amount of debt means nothing to them. They're already knee-deep in debt paying back a lifetime of loans or medical issues. You're acting like people are paying the extra $40,000 upfront when in reality those costs are distributed out over the lifetime of a patient post-operation. Debt becomes more and more meaningless as you accept you can never afford to pay it back, so you focus on the immediate problems over the long terms.

In fact this is why hospitals have so many issues. They can't actually get any money (you know, blood from a stone and all that) from the poor, so they squeeze money from the middle class and up in order to keep on the lights. The result is higher prices across the board for ludicrous things.

>But then they're not actually paying it. When charging $50,000 only means that it selects exclusively for people who will file for bankruptcy, the provider who does that is headed for bankruptcy itself, to be replaced by someone who realizes it's better to get $10,000 90% of the time than $50,000 ~0% of the time.

If that was true, then the system wouldn't have the problems that it does, now does it? It's simple and I'm sad I have to break this down to you: They charge ludicrous amounts knowing that they'll either get the baseline from the poor people over time ($10,000), or they'll get the absurdly overpriced amount from people that can afford it. This is why doctors and hospitals become debt collectors.

>Isn't this just emergency care again? Emergency care is different. It makes sense to have the locality provide it in the same way they provide fire departments, with the purpose to stabilize the situation to the point that you (or whoever is making your decisions) has a chance to assess things and make a reasoned choice how to proceed further. It's also a small proportion of overall medical costs.

No, emergency care is not different. We have Americans using emergency care more and more often because the cost of regular care is through the roof. Even if prices were transparent, poor Americans that can't afford even basic preventative care will still end up further burdening emergency care because of how fucked up our system is.

>This kind of policy choice is literally a matter of life and death. Don't pretend you know the answer before you've had the debate. Being wrong is killing people one way or the other.

You're right it's a matter of life and death. Which is why I argue so vigorously against bullshit solutions that do nothing to solve the problems that are brought up by people that have never had to deal with the depths of poverty or the shit poor/rural people have to put up with. Price transparency is nothing more than a feel-good measure that slaps a band-aid on the problem for upper-middle class people while continuing to give a middle-finger to the poor. The market is broken much like how the ISP market is a sham and thinking that competition will magically pop up if we just implement one or two changes like this is folly.

I've seen and experienced what it can do to families.