Price shopping happens when the payer is directly affected by the costs (note: you mentioned your mother is uninsured) and when you can evaluate the quality (or don't care). It's actually very difficult to evaluate who's good and who isn't because a) statistics aren't often released (because hospitals and doctors block them) and b) the statistics can be difficult to interpret (a good doctor with bad stats can just have a sicker overall population). A big problem was that the data capture to adjust for these factors wasn't there (records were frequently kept on paper and billing codes barely correspond to reality). A big problem has been simply that even when the data was there, it is incredibly expensive to aggregate and report it.
In the US, we are attempting to fix some of these things. Medicare has implemented Quality Metrics and the requirement that doctors implement electronic medical record systems that measure some of the easier things to measure (patient counseled about managing diabetes, summary slip issued at end of visit, et cetera). Hopefully, price transparency plus a modern statistical reporting system will result in price shopping being viable in the next decade (of course the patient must be willing to discriminate).
Price shopping happens when the payer is directly affected by the costs (note: you mentioned your mother is uninsured) and when you can evaluate the quality (or don't care). It's actually very difficult to evaluate who's good and who isn't because a) statistics aren't often released (because hospitals and doctors block them) and b) the statistics can be difficult to interpret (a good doctor with bad stats can just have a sicker overall population). A big problem was that the data capture to adjust for these factors wasn't there (records were frequently kept on paper and billing codes barely correspond to reality). A big problem has been simply that even when the data was there, it is incredibly expensive to aggregate and report it.
In the US, we are attempting to fix some of these things. Medicare has implemented Quality Metrics and the requirement that doctors implement electronic medical record systems that measure some of the easier things to measure (patient counseled about managing diabetes, summary slip issued at end of visit, et cetera). Hopefully, price transparency plus a modern statistical reporting system will result in price shopping being viable in the next decade (of course the patient must be willing to discriminate).