You go to a restaurant, peruse the menu, take your waiter's suggestions, and order a meal. But there is something odd: the menu has no prices and you have no idea what you will be required to pay until a few weeks later when the bill arrives in the mail.

That, it turns out, is analogous to what goes on in health care, where fees are hidden at the time of service. Making matters even worse, patients often are seeking care when they are frightened and vulnerable, in no position to ask about prices or haggle.

This is the lead to a good NYT story today about the hidden nature of health care costs, but it leaves readers believing that visiting an out-of-network provider and paying their often exorbitant and surprising costs is the choice of the patient or the result of patients' oversight...

Even well-insured and sophisticated health economists, like Dr. Garber, an adviser to Dr. Colella’s company, can be hit by unexpected fees. When his wife had a baby, an anesthesiologist spent a few minutes administering an epidural anesthetic. Dr. Garber assumed the doctor was part of his insurance plan—the hospital participated in the plan and the doctor had not said he did not. But then the bill came for a few thousand dollars, and it was up to Dr. Garber and his wife to pay it.

But then last year I had a weird, possibly cancerous tumor in my leg and there were no in-network doctors who dealt with such things. Since all the in-network doctors agreed that he was the only one I could see, you might assume (as I did) that my insurance would cover him as a network provider.

Instead, I discovered that my typical employer-provided insurance plan had a contingent for such cases: they'd only cover 50 percent—even though I had no in-network option.

One solution proposed by the Obama administration—improving networks so that patients can stay in-network—is, sadly, another recipe for wasting health care doctors. Why should every network have a specialist to deal with every rare medical condition? Wouldn't it make more sense to make insurance cover what doctors think a patient needs, regardless of arbitrary networks? Of course it would.

This is only one example of how what's being argued about currently isn't really giving anyone much to feel hopeful about.