So, now we know how much Blue Cross and Blue Shield of N.C. pays for an average insured's heart bypass surgery: $57,280. Assuming we don't suffer a heart attack from sticker shock, what do we do with that price tag? Shop around for bypass surgery?

Maybe not, but give Blue Cross a dose of credit for making available online, to its 3.6 million members, typical North Carolina prices for hundreds of medical services, from flu shots to heart surgery. The high cost of health care, after all, is a huge problem. It drives health insurance rates ever higher, and evidence suggests this country isn't getting the payoff in health-care outcomes that its world-leading level of spending should bring.

Bringing specific costs to light can't hurt. That said, will it help? And if so, how?

For most people with conventional health insurance, knowing the average costs that Blue Cross pays statewide is of little value. They already have a doctor, and they're probably not keen to switch. When they need medical care they see the doctor, get treated and pay the bill -- or rather, hand over their insurance card at the billing office, pay the co-pay and hope that after the resulting blizzard of bills and "This is Not a Bill" notices, the bottom line doesn't hurt.

That's our system. It's accused, with justification, of driving up costs, in that there's no direct connection between the patient's wallet and the price of the service or product he or she is buying. So medical providers jack up the fees and insurers clamp down on what they'll pay -- a confusing and unseemly system.

In such a setup it's not likely that the patient will bargain with the doctor over the fee -- either for a physical or for brain surgery, let alone emergency care.

But an emerging alternative to conventional health insurance is the Health Savings Account, or HSA. Touted as a money-saver for consumers and for employers who offer health insurance, an HSA makes you use your own money (or funds set aside by your employer) to pay for medical expenses until a high yearly deductible -- $1,000, $2,000 or more -- is met. Above that, conventional insurance kicks in.

The cost calculator was created for this sort of plan. One criticism of the high-deductible concept is that, while it puts pressure on patients to act as cost-conscious consumers, cost information has been hard to come by. Now "typical" Blue Cross payments will be online. Individual providers' charges will not be, so this is a benchmark, not comparison shopping. Yet it's worthwhile to see how much the costs of certain procedures -- colonoscopies, for example -- vary with the setting in which they're done.

Overall, however, there's a limit to what cost-consciousness can or should accomplish here. Medical expenses are rising for all sorts of reasons, including high-tech equipment, health workers' pay and the enormous sums spent on people in dire medical straits -- not to mention the costs of insurers' overhead.

Not much of that is under the patient's control, nor could it be. A focus on patients as consumers/customers can go only so far. These are, above all, human beings in need of health care, and entitled to it. First-rate health care.

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