Why I Built Panopticare

If you want to see what healthcare could look like with real price competition, look at LASIK. It's elective, it's not covered by insurance, and patients pay out of pocket. Because of this, LASIK providers compete on price in a way that virtually no other healthcare service does. Clinics publish their prices on their websites. They offer package deals. They compete on cost, technology, and outcomes. You can call five places, get five quotes, and compare them side by side.

The results speak for themselves: the average cost of LASIK has dropped about 30% in real terms over the past two decades, while the technology has gotten dramatically better. More competition, better outcomes, lower prices. It's the healthcare version of what happens in every other functioning market.

Now Compare That to Everything Else

Take a knee replacement. The same procedure, at hospitals within a few miles of each other, can vary by a factor of five or more. Patients usually don't find out the price until after the surgery, when the bill arrives. Try calling a hospital and asking what a basic blood panel costs. You'll get transferred three times and told they can't give you a number until after it's billed to your insurance.

The difference isn't that knee replacements are inherently harder to price than LASIK. It's that the information infrastructure doesn't exist. Patients can't compare, so hospitals don't compete on price, so prices stay opaque, so patients can't compare. It's a cycle, and it's been spinning for decades.

The LASIK example proves something important: healthcare can work like a market. It can have transparent pricing, consumer choice, and price competition. It just currently doesn't for the vast majority of services.

The Data Exists (Sort Of)

Since 2021, hospitals have been required to publish their prices in machine-readable formats. So I went looking for them. What I found was a mess. Some hospitals buried the links. Others published files so poorly formatted they were basically unusable. Many just didn't comply at all, because the penalties were too small to matter. And even the good files were massive CSV dumps that required significant technical skill to work with.

I also discovered the Transparency in Coverage rule, which requires insurance companies to publish their negotiated rates. Same story: enormous JSON files, inconsistent formats, and no consumer-facing interface. The data existed, technically, but it might as well have been locked in a vault.

I kept thinking: somebody should build a tool that takes all this data, cleans it up, and presents it in a way that normal people can actually use. I waited for someone to do it. Then I realized that maybe I should just do it myself.

What Panopticare Actually Does

The core idea behind Panopticare is simple: take publicly available healthcare pricing data and make it useful. We pull in machine-readable pricing files from hospitals, ingest Transparency in Coverage data from major insurers, and normalize everything into a consistent, searchable format.

When you search for a procedure on Panopticare, we show you what different hospitals charge, what your specific insurer has negotiated, and how those prices compare. You can filter by location, by insurance, by procedure type. The search is fast, the results are readable, and you don't need a medical billing degree to understand them.

The technical challenges were significant. Hospital files use inconsistent naming. One hospital calls it "Total Knee Arthroplasty," another calls it "TKA - Knee Replacement," another uses just a CPT code. We built a registry of over 15,000 procedures with 75,000 aliases to handle this. We use semantic search so you can type "knee surgery" and get relevant results even if no hospital uses those exact words. We cross-reference hospital prices with insurer-negotiated rates so you can see what you'd actually pay, not just the list price.

We started with the Chicago area because that's where I am and it's a large enough market to be meaningful. We're now pulling in data from over a hundred hospitals and processing more than a million payer-specific rates.

The Vision

I don't think Panopticare alone is going to fix healthcare pricing. The problems are systemic: deep-rooted incentive structures, regulatory capture, decades of entrenched opacity. But I do think that giving people access to price information, in a format they can actually use, is a necessary first step.

The LASIK market works because patients can compare prices. If we can create something similar for the hundreds of shoppable healthcare services that patients schedule every day (imaging, lab work, outpatient procedures, even some surgeries), the competitive dynamics start to shift. Hospitals that charge 3x the market rate for an MRI have to answer for it when patients can see that on a screen before they schedule.

We're early. The data is still messy, compliance is still low, and most patients still don't know they can comparison-shop for healthcare. But the direction is clear, and it's accelerating. Federal enforcement is ramping up. State legislation is emerging. And tools like ours are getting better at turning raw data into actionable information.

I built Panopticare because the gap between how LASIK pricing works and how everything else works is absurd, and fixable. The data is there. The technology is there. What's missing is the connective tissue that turns raw hospital files into something a normal person can use to make a decision. That's what this project is designed to be.