Pregnant women lead the way in shopping for health care

Yesterday I contrasted consumer businesses --where sophisticated customers are in the driver's seat-- with health care, where they aren't. In consumer businesses, like computers, detailed quality and technical information is widely available. And of course prices are posted. None of this is so in health care.Despite the challenges, unininsured and under-insured pregnant couples are using their sophisticated shopping talents to finding good, affordable maternity care, according to the Wall Street Journal (Childbirth for Bargain-Hunters). They are buying maternity discount cards, such as MaternityCard, and also attempting to negotiate rates with doctors and hospitals, using insurance company reimbursements as their price benchmarks. It's somewhat reminiscent of how automotive pricing transparency evolved. Everyone used to deal with sticker prices, then slowly adopted Edmunds for dealer cost data and used buying clubs with pre-negotiated discounts. Now, even the dealers quote their prices relative to the invoice.Childbirth is a clear place to expect consumers to try to take charge. Pregnant couples have an extended encounter with the health care system, giving them time to shop and deal. It's also often a repeat experience, so the couple knows more-or-less what's involved. Pregnant women are usually healthy, so they have the energy to confront the system. And pregnancy is for younger people who are more apt to view health care as a consumer service industry and want to engage with their caregivers on a more equal basis.