When hospitals buy a medical device, they sign a confidentiality agreement which, among other things, says that the hospital cannot reveal how much they paid for the device. This puts the hospital at a distinct disadvantage; they don't know what other hospitals have paid and really can't judge whether they have gotten a fair price or not.
Medical device companies play the sales game in interesting ways. One way is to hire doctors as consultants; strangely, the doctors they hire usually have a big say in what devices the hospital buys.
Maybe that's why the GAO found that medical devices bought in the U.S. cost more than the same device bought overseas. In some cases we - you and I whether or not we have Medicare or insurance - pay 50% more.
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