Health Care World vs. Girl World: Patient Price Shopping


Learning about the world of health care price transparency doesn’t have to be boring. Thinking about ways to better explain the elements at play in the U.S. health system, we were able to recognize a some interesting parallels between the girl-world, created in the brilliant mind of Tina Fey in cult-classic Mean Girls, and the health care world.  If you’ve never seen Mean Girls, let this be your excuse to imbibe in some guilty-pleasure, movie viewing time.

For those that have never had the pleasure of watching Mean Girls, the premise is as follows; the main character Cady has been homeschooled her whole life. While living in Africa, her parents decide to socialize her by moving her back to America and enrolling her in a public high school. She makes friends with a couple free-spirited art students, who convince Cady to swindle her way into the inner-circle of “The Plastics.” “The Plastics” are the popular, mean girls whose lives they infiltrate, to learn their secrets and manipulate their power.

WATCH: Mean Girls Trailer

We won’t ruin the ending for you, but we will point out the areas where we were able to compare Cady’s high school experience, to the patient experience in an ever-changing health care industry.

1.     “I got in trouble for the weirdest things.”

On her first day at school, Cady gets scolded for doing just about everything wrong, such as getting up to go to the restroom without asking. Cady’s problem is that she is very intelligent, but cannot navigate the system of high school due to her lack of knowledge in that “niche-market.” This is the same issue that patients face when it comes to navigating the world of consumerism in health care. Patients want independence, the freedom to price shop and compare different physicians and procedures. However, while patients know what they want, they don’t know how to discern their best options thanks to the lack of transparency in the health care system.

2.     “That’s why her hair is so big, it’s full of secrets.”

Gretchen Weiner’s, voluminous locks are so big because they’re full of everyone’s secrets, which is how she can manipulate people so easily. In the health care world, our hospital systems are just like Gretchen Weiners and “The Plastics.” Built big and beautiful, with immense staff and unlimited marketing budgets fueled by secret fees and hidden costs, hospitals are able to make huge profits off of patients and insurance companies.  Hospitals can easily manipulate payers due to their hospital bill secrets and ability to dumbfound payers with unfair charges.

3.     “I saw Cady Heron Wearing Army Pants and Flip Flops, so I bought Army Pants and Flip Flops.”

how much does an MRI costThe real problem lies in the fact that many patients often look to hospital systems for guidance, setting the standards for patient care. The female students in Mean Girls follow the same path when it comes to giving authority to “The Plastics,” following blindly without question.

4.     “You can’t join the Mathletes, it’s social suicide!”

When Cady thinks about joining the Mathletes, both sectors of her friends warn her against it, acting as her choice architects. By dictating her activities, despite her best interest, her friends are trying to protect their own social standings.  Unfortunately, referring physicians often treat their patients the same way. Not to say that doctors are not looking out for their patients’ best interest with respect to care, however it is not their job to be concerned with the best interest of those patients’ wallets.  Additionally, there is no way of discerning why a physician might refer to one specialist over another, this skewed reasoning is why transparency in the market is necessary. With better access to pricing and quality information; patients can be better educated, more powerful and serve as their own choice architects.

5.    “Were people nice?” “No.” “Did you make any friends?” “Yes.”

Cady realizes slowly that her peers are much like the wild animals she left behind in Africa and decides that while they are unpredictable and manipulative, she must make friends to survive in the high school food chain.  The same could be said about the quality of certain health care institutions, where the care is not necessarily personalized and nice, but patients go there anyway out of desperation or the lack of knowledge that they have other options.  Eventually, Cady reorganizes the system and gets her peers to realize that by being “transparent” and being themselves, they can form stronger relationships and be much happier. Patients must do the same when it comes to selecting their doctors.  Asking for transparency so that patients can determine what is important to them as far as their care goes, allows them to be more educated patient-consumers, which will lead to lower health care costs and a better patient process.

The point we’re trying to get to, is that while your high school experience might not have been exactly like Cady’s experience portrayed in Mean Girls, it is likely that you’ve faced some of these issues and used your experience to come out on top. Patients can do the same thing if they just ask questions, demand transparency and take back the wheel of their own care.