In this recent story for NPR - That Surgery Might Cost You a Lot Less in Another Town - the reporters shine the light on cost differentials for the same procedures at various places of service across cities.
Yes, the price differentials between states and between cities and states are huge. An important part of the story that was missed was the huge differentials inside cites everywhere in America. Heck, it's inside neighborhoods.
In Phoenix, one only needs to drive across the street to see meaningful savings. A major insurance company will pay from $15K to $46K for a knee replacement depending on the facility the service is done in. And from $3200 to $14,000 for a gall bladder surgery. And it's driven by only market share and negotiating clout, never by quality or anything else that is important to the consumer. It could even be the same doctor!
This one issue, if fixed, would be the single most impactful thing that could happen to make healthcare affordably accessible to all Americans. Guess what?....Protection from price differentials is already true for Medicare. Unfortunately, it isn't true for Obamacare.
Let me buy Medicare for my family and for my business, and my healthcare affordability issues go away. Heck, I'd happily pay more than my share for this option.