---
title: "House Oversight: Estate Documents (Nov 12) (HOUSE_OVERSIGHT_020992)"
source: "House Oversight: Estate Documents (Nov 12)"
sourceUrl: "https://www.justice.gov/epstein"
date: "2026-01-01"
category: "House Oversight"
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Restructure Medicare & Medicaid: Economic Factors—
Poor Information & Lack of Price Transparency
Make it Harder for Consumers to "Comparison Shop"
Patients are at a healthcare information disadvantage in two respects:
• Lack of transparency:
> It's harder for consumers to compare prices of healthcare services from
different healthcare providers than in other consumer markets given the
complexity of healthcare market.
> With employer- / government-subsidized insurance, many patients are
'locked in' with their insurance plans that do not incentivize "shopping
around."
• Knowledge gap:
> Unlike other markets where consumers tend to use their own information and
preferences, consumers depend more on the advice and guidance of
physicians or other healthcare suppliers.
> Unlike other "merchandise," healthcare is literally of life-and-death
importance to consumers, making risk aversion - and price
insensitivity - higher. This price insensitivity is exacerbated because the
consumer, in effect, gets it at a discounted price anyway.
Source: 1) Accounting for the cost of US healthcare, McKinsey Global Institute
www.kpcb.com
USA Inc. | What Might a Turnaround Expert Consider? 301
Restructure Medicare & Medicaid: Economic Factors—
Consumers Increasingly Demand Expensive Treatment and Are Able to
Pay for it With Government Subsidies
Total High-End Surgeries up 50x from 1970-2004, Driven by Medical
Advancements + Consumer Ability to Spend Assisted by Government Payments
# of Patients (Aged 50+) Undergoing Typical Costs per
Advanced Procedures in USA
Procedure ($)
1970
2004
Coronary Procedures
Angioplasty / Stent
Implantation
Pacemaker / ICD^
Bypass
<20,000
1.1 million
$12,000
<10,000
<10,000
Dialysis Procedures
<10,000
350,000
220,000
480,000
$15-34,000
$28,000
$24-72,000 per
year
Joint Replacement Procedures
Hip
Knee
3 www.kpcb.com
<20,000
--
390,000
$12,500
440,000
$12,500
Note: 1) /CD is Implantable Cardioverter Defibrillator, which is similar to a pacemaker but for a heart rhythm that beats too fast.
Cost of procedure approximated by Medicare reimbursement.
USA Inc. | What Might a Turnaround Expert Consider? 302
HOUSE
_OVERSIGHT_020992