For decades, U.S. healthcare has operated as a market without visible prices — an anomaly unlike almost any other sector of the economy. How Healthcare Became a Market Without Visible Prices explores how this system evolved, tracing the shift from direct-pay medicine to a complex web of insurance, contracts, and payment models that embedded prices deep within private negotiations. The paper explains why transparency efforts historically fell short, and how well-intentioned reforms often increased complexity without improving real-world decision-making.

Today, healthcare has crossed a one-way threshold. Federal transparency rules have made negotiated prices technically public, but disclosure alone has not created accountability, competition, or better purchasing decisions. This paper argues that the next phase of price transparency will be defined by whether the industry can convert fragmented disclosures into trusted, decision-ready intelligence. Doing so is critical to improving negotiations, enabling smarter purchasing, informing policy, and ultimately restoring price as a meaningful economic signal in healthcare.

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