At a time when health care spending seems only to go up, an initiative in California has slashed the prices of many common procedures. The California Public Employees' Retirement System (Calpers) started paying hospitals differently for 450,000 of its members beginning in 2011. It set a maximum contribution it would make toward what a hospital was paid for knee and hip replacement surgery, colonoscopies, cataract removal surgery, and several other elective procedures. Under this new approach, called reference pricing, patients who wished to get a procedure at a higher-priced hospital paid the difference themselves. And reference pricing is the topic of this week's Healthcare Triage. This episode was adapted from a column friend-of-the-show Austin Frakt wrote for the Upshot. Links to references and further reading can be found there: http://www.nytimes.com/2015/10/20/upshot/to-reduce-the-cost-of-drugs-look-to-europe.html?_r=0 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com