Insurance plans limit doctor, hospital choice

The success of medical pricing transparency depends on the existence of a variety of choices. Many insurance plans, employer-based as well as Medicare, have HMOs or PPOs, which restrict choice of physician or hospital, or provide financial penalties for going outside the network.

Linn County does not have the full range of specialists that the University of Iowa has. It was only a year or so ago that Linn County obtained its first - and only - board-certified endocrinologist. Where there are specialists, competition is limited, certainly, because of the population base.

UI might be outside of the HMO or PPO. As much to the point, UI might not be accessible for the 7 percent of households without a car, or those who have some form of disability or age-related problems (12 percent of Linn County is over age 65).

Medical pricing transparency depends on the existence of choice, and for many, there are no choices.

Niles Ross

Cedar Rapids