Haggling a casualty of retail modernization

Don’t snag patient switch

Unless you find yourself at a flea market, rummage sale or some other place where second-hand goods are exchanged, you probably don’t haggle. Few of us would consider dickering about the price of goods in retail establishments, and bargaining is certainly out of the question at chain stores.

This wasn’t always so. Nineteenth-century customers haggled and bartered over just about everything, managing to bring order to a seemingly chaotic commercial system. Customers lacking hard currency routinely exchanged eggs, butter or even services for dry goods as disparate as flour and pieces of china. The price of goods also depended on how one was paying — with cash or on credit — and whether one had a favorable relationship with a particular store clerk.

But bartering and haggling began to lose favor with the rise of so-called one-price (or “fixed-price”) stores in the 1830s and 1840s. Many retailers came to realize that they could sell more goods by eliminating the vagaries of haggling.

Americans were slow to embrace the fixed-price system, even though buyers and sellers alike agreed that haggling was highly fraught and engendered distrust and anxiety. Merchants described being repeatedly “beaten down” by aggressive customers who aimed to buy as cheaply as possible, regardless of an item’s legitimate worth. Buyers often felt like victims of sharp clerks

I just read your article about the angst patients are having when they want to follow their physicians who leave one practice for another (“Patients May Suffer As Doctors Switch Practices, Health Systems,” Sept. 26). Withholding information, preventing continuity of care to patients and interfering with the patient/doctor relationship is ethically and morally wrong.

The last thing patients need is to have to start all over with a new physician just because the one they’ve worked with for decades has moved across a river or down the street to a new health care system. Having to have multiple appointments so the “new” doctor gets up to speed on their care, having repeat tests adds to the economic burden patients DON’T need and only fills the coffers of the health system.

The PA Medical Association has been vocal about the UPMC/Highmark contract disputes when it comes to continuity of patient care.

As a large number of the physicians belong to the PA Medical Association, (an unbiased medical organization) perhaps with a little prompting by a reporter/consumer advocate, the PAMA (or some other professional organization) might consider posting announcements on physician relocations so that other colleagues/patients can find them. It may be a way to get around the restrictive contract clauses that prevent physicians from contacting their patients. And would put the onus on patients to look them up on the website. It would be helpful if it were one website.

Thank you for putting faces and names to this regional crisis and facilitating caring back into health care. PATRICIA SCHAEFER, RN BSN M.DIV

Edgewood with well-honed bargaining skills, and thought they too often overpaid.

Retailers instituting one-price systems insisted it was for the benefit of their customers. But it also made great business sense. By eliminating haggling, store owners traded the potential of larger profits on fewer sales for smaller profits on many more sales. By rapidly turning over stock, seemingly meager profits quickly added up.

Perhaps most important, one-price stores let merchants hire unskilled workers who required no knowledge about the stock on hand or bargaining skills to make a sale.

Due to significant socioeconomic shifts including the second industrial revolution, merchants came to rely on unskilled and primarily female labor in the following decades.

By the end of the 19th century, fixed-price stores were the norm rather than the exception. Today the fixed price has become such an integral part of retailing that, outside of flea markets and car dealers, the idea of negotiating a price seems almost absurd. Blue Cross, I want to acknowledge the Post-Gazette’s informative article “Highmark To Handle Data For Philly Insurer” and provide some background about how our decision to select Highmark as our operating platform vendor fits into our business strategy as one of the nation’s leading health insurers.

We considered other national vendors during a thorough selection process, and chose Highmark because its system proved to be the best, hands down.

By contracting with Pittsburgh-based Highmark, we are investing in the commonwealth and keeping jobs here in our great home state to support our expanding portfolio of businesses and products.

Also, by capitalizing on one of Highmark’s strengths, we can continue to focus on serving our 3 million-plus (and increasing) customers in southeastern Pennsylvania and across the country.

Right now, Independence Blue Cross is one of the fastest growing health insurers in the country. For example, recently we led a transaction with other Blue health insurers and the leading technology company Lumeris to purchase NaviNet, the nation’s largest real-time communication network for physicians, hospitals and health insurers. We are also pioneering innovative ways to reward hospitals and physicians for higher-quality care and more effective care coordination.

In fact, a recent report in HealthLeaders InterStudy named the top five health plans “best positioned for 2014 reforms.” We are proud that Independence and our national Medicaid subsidiary are listed as one of those leading organizations.

We are pleased to include Highmark in our ambitious efforts to change the game! DANIEL J. HILFERTY

President and CEO Independence Blue Cross