To the editor: As an internist with 40 years of experience, I will tell you that barriers, cost or otherwise, do not make healthcare better or more efficient. (“Trying to shop for medical care? Lots of luck with that,” Sept. 26)

On the contrary, they more often promote poor choices, such as choosing doctor visits for colds and muscle strains, which are unlikely to make a significant difference, over treatment for hypertension or diabetes, which is likely to have a major impact.

Value in healthcare is about getting the best quality for one’s available resources, just like in everything else. This article shows us how there is grossly insufficient information to truly determine costs.

I assure you that determining quality is even more difficult for the layperson. It is a tough hurdle for various ideologies to overcome, but specifically in healthcare, excellence will much more likely result from cooperation instead of competition.


Hyman J. Milstein, M.D., Studio City

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To the editor: A mechanic who needs to make a repair to your vehicle looks in the flat-rate manual for the year, make and model of your car, which details how long the job should take. Your mechanic can then give you a cost estimate.

What the country needs is a flat-rate manual for all medical procedures. It should be exhaustive — for example, if you choose an in-network hospital that only has out-of-network anesthetists, then this information should also be listed, along with the in-network costs where applicable and the out-of-network costs otherwise.


Without such a universally accepted pricing tool, no matter how hard you try, you will never know going in what anything will cost. Because of this, adopting a single-payer system has grown in popularity.

One way or another, the American people need some concrete way to bring medical costs under control and in a way they can understand.

Gregg B. White, Big Bear City, Calif.

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To the editor: In March 2018, I was riding my motor scooter to work when I had an accident and broke my shoulder. In that moment, I did not see any choice but to agree to be transported to the local hospital in Santa Barbara. Shopping for healthcare was the last thing on my mind.

A few months later, it was determined that I needed surgery. For that I shopped around.

Six months after my accident, I had surgery to repair my shoulder. My surgeon, who specializes in shoulders and elbows, did an excellent job. A doctor back in Santa Barbara noted how well I had healed and told me what I did was the best way to go.

My point is that for this needed surgery, I shopped around not for price, but for quality. The hospital where I stayed, White Memorial in Boyle Heights, provided superb care. I had never heard of this hospital, but I would go there again, and I found out months later that having the procedure locally would have incurred a much higher cost.


I think most people first look for quality, especially in a case like mine.

Kevin Rose, Goleta