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The wonderfully helpful NYTimes series Patient Money reported Friday on the topic of Opaque Inc., as posted recently here by Gilles. The article, Bargaining Down the Medical Bills, gives practical advice about how to negotiate your doctor, lab, and hospital fees. The good news about the bad economy is that the skyrocketing number of uninsured, brought on by 8.5% unemployment, might also bring on a speedy unraveling of jacked-up pricing and obfuscatory practices:

Lately, Dr. Moritz said, “The first thing I say to my long-term patients is, ‘Do you still have a job?’ ” If patients say no, or otherwise indicate that paying will not be easy, Dr. Moritz says he assures them that bills are negotiable. And keep in mind that doctors, hospitals and medical labs are accustomed to negotiating. After all, they do it all the time with insurers. A hospital may have a dozen or more rates for one procedure, depending on whether Medicare, Medicaid or a private insurer is paying the bill… Your request for a special arrangement will hardly confound their accounting department.

So at the very least, if we can’t force transparency in this weirdly non-market-driven, trillion-dollar sector of the U.S. economy, we can start bargaining with with the sellers, in the same way my son reports is expected in the market stalls of Kolkata. Is this really the smartest way to move toward affordable health care? And keep in mind that patients are not the only losers in this equation.

Like doctors, hospitals would rather be paid something than nothing. They lost $34 billion in 2007 on uncompensated care, up 55 percent from 2002.

If we’re all in the same boat, how about bypassing the system altogether and move to a bartering economy? “I’ll edit your son’s college application essay if you’ll give me a colonoscopy…..” “Winterize your house in exchange for an annual checkup.” “Guitar lessons for post-knee-replacement physical therapy.” Makes more sense than what we’ve got now, in a WYSIWYG sort of way.