Most would agree that healthcare is a major purchase. Whether it is for insurance or for out-of-pocket expenses, you are usually talking about hundreds, if not several thousand dollars per year. So how do healthcare customers make good, informed decisions about how to get the most out of their healthcare purchases?

Patients when shopping for consumer goods can compare products by researching descriptions, capabilities, specifications and reviews based on other consumer experiences.

We can then determine where to make the purchase, based on supplier credibility, location (store or online), and price (including tax and handling fees). We can decide to purchase a more expensive product if we feel we need it or just want whatever the more expensive product has to offer.

The same, but perhaps to a lesser extent, holds true for service providers. With most services, we have a clear idea as to what we need done by the provider, even if we don’t necessarily know how to do it ourselves.

Reputation and referrals from friends are often where we might start, but then we also might have Internet consumer ratings and reviews with testimonials. It is also easy to get a quote or estimate specifying what will be done and at what price. It is easy to compare before we decide.

However, when customers need healthcare, how can they possibly make an informed decision about where to be treated? Patients can look for providers in a phonebook or online. Sometimes insurers provide a list of physicians (not recommendations) with their noted specialties, phone numbers and addresses.

If we’re lucky, we have friends or relatives who can suggest somebody that they have used and liked. And, of course, we can get a second opinion to determine whether or not we should have surgery and what type of surgery.

So, what real information do we have to help us make an informed decision about healthcare provider choice? Not much. While we know it isn't true, we are left to assume that all providers (physicians, hospitals and laboratories) deliver equal or similar care.

And as for pricing? "It's to complex" for us consumers to understand and "it depends." So we are left to trust that care will be reasonably priced regardless of where we go. Besides, we really don’t need to know pricing when insurance or the government is paying for it anyway, right?

While it is difficult for patients to make informed decisions without the necessary information, especially pricing, there is an even bigger downside. This lack of transparency provides shelter for unscrupulous and incompetent healthcare providers.

Unfortunately, medical degrees and hospital accreditations do not assure competency or pricing fairness. Moreover, the complexity of the nontransparent pricing makes it easy to inappropriately rack up charges. With little leverage, it is virtually impossible for individuals, especially the uninsured, to challenge pricing.

So much for “buyer beware.”