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355 points pavel_lishin | 2 comments | | HN request time: 0.545s | source
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RobKohr ◴[] No.45389953[source]
"Federal funding typically covers 80% of bus purchases, with agencies responsible for the remainder."

Well, there is your answer. The one making the purchase isn't the one primarily paying for the purchase. This makes them less sensitive to pricing.

Kinda like how expensive healthcare is since it is paid for by insurance.

Or how you don't care how much you put on your plate or what you choose to eat at an all you can eat buffet.

The second you detach the consumer from the price of something, even through an intermediary such as health insurance, that is when they stop caring about how much something costs, and so the price jumps.

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qgin ◴[] No.45392764[source]
I have a $6500 deductible. I definitely care what things cost because my insurance almost never actually helps pay for anything unless I have an unbelievably bad year.

The problem is that literally nobody can tell me how much anything is going to cost until I get the bill in a month. Not even because they don't want to tell me. Nobody at the desk even knows what my price is going to be because it's all numberwang.

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1. kortilla ◴[] No.45393627[source]
You care about small costs but not the large ones. Even with a relatively large deductible it’s irrelevant to you if your hospital charges $50k or $90k for a surgery.

$6500 is nothing once surgery, radiation, and/or anesthesiology enters the picture.

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2. qgin ◴[] No.45397907[source]
Absolutely, there is room for price shopping for a subset of medical treatments. https://surgerycenterok.com is a well-known cash-pay surgery center. If you look through the procedure list, you can see the types of things that lend themselves to this model: lots of orthopedic surgeries, things that are fixes for chronic issues that don't really need to be dealt with on any specific timeframe.

But when you get into the really big, serious, time-sensitive things. Cancer treatment, heart disease, anything that starts with an ER visit... you don't really have an ability or time to "shop around". The demand is inelastic.