I agree that much of the general public is insulated from price, however a few personal observations: (Note: I worked for 8 years for a state insurance company and my wife has been a nurse practitioner for 12 years)

People don't "shop" for healthcare the same way they shop for televisions or other consumer products. In fact the overwhelming majority tend not to all. Either someone like me at their insurance company picks a primary care physician for them, or they pick one from a list based on simple factors like someplace convenient, seems like it's a good part of town, etc. Unless the doctor is so unbelievably terrible, it's extremely unlikely they will switch. My wife, who is frustrated by many aspects of our healthcare system, attributes much of this to the complete and utter lack of medical literacy possessed by the general population. The average person simply has no idea how modern medicine works on any substantial level, so they have little to no basis for making an informed decision about their care or provider. When you are sick, even with something routine and non life-threatening, you don't think "Hmm I could go see the doctor today because I feel awful, but I think I'll price shop for a day or two beforehand." Even people with strong financial incentive, i.e., people with limited means, don't do this. If a child or loved one is involved you're even less likely to start thinking about dollars over medicine.

I do agree that most patients have no accurate understanding of the real cost of their care, and that more education in that department certainly can't hurt, but no matter how you slice it, that cost is simply much higher than it is in other developed societies, and that is a serious problem that needs to be addressed.

Edit: Something I wanted add: I know in a community like HN, many will be of the sentiment that if you fail to educate yourself about a product or service, you borderline deserve the consequences. I agree with this in most respects. However, taken to it's logical conclusion, that would require me to become an expert on everything under the sun. I have no idea how the plumbing in my home works, or how to do anything but routine maintenance on my car. It's not that I lack the interest to learn about these things, it's simply that there aren't enough hours in the day to plausibly accomplish this. When faced with the need of a professional expert, I have to use a little common sense mixed in with any superficial knowledge I do have, and trust that there is a system in place that prevents me from being totally screwed price wise.

This article suggests that shopping around for, say, knee replacement surgery, is not so simple:

http://www.washingtonpost.com/blogs/ezra-klein/post/how-much...

My Mom (no insurance) shops around as follows: "Hi, I'm told I need X done, but I need to know the price. I don't have insurance, and I want to make sure I have enough money to pay for it."

She tends to get accurate estimates, probably because hospitals don't like to hear "I thought it only cost $X, I don't have $X + $Y, so, umm..."

Granted, what she gets isn't likely to be a "a complete cost estimate [...], [...] reflective of any negotiated discounts, [...] inclusive of all associated costs, and did not identify consumers’ out-of-pocket costs", which is what the GAO wanted. But it's certainly good enough for shopping around.