Hey pal, looking for a pickup truck? I have a 2004 Ford F-150 for you. How's $102,478 sound? Crazy? When it comes to their health care, Americans accept deals like that every day, paying twice to 10 times more than others pay for the same services of the same quality not just in another country, but in the next county, down the street — or even in the same facility. Why? In the fee-for-service system we pay for items rather than results — and the sellers mostly decide what we need. Insurance separates the buyer into two parties: patient and payer. Secret contracts and lack of quality information make it all but impossible to comparison shop.