Sorry, if you read the title of this post and thought “Obamacare,” “government,” or “insurance policy” you came to the wrong place. The story I’m highlighting was written by a physician whose patient decided to forego his bare-bones insurance policy and pay cash for a surgery he needed. The patient saved about $17,000, and the providers were happy because they didn’t have to deal with the red tape.
Hospitals and other providers make their “list” prices as high as possible when negotiating contracts with health plans and Medicare regulators. No one is ever expected to pay the list price. Anybody who has seen an “Explanation of Benefits” statement from a health plan will note a very high charge from the provider, and an “adjusted charge” based upon the contracted fee schedule, which usually leaves the patient with little or nothing in out-of-pocket expenses. The only people routinely faced with list prices are those few people who have insurance like my patient’s—that doesn’t include a pre-negotiated fee schedule with contracted providers—or those who have no insurance.
Most people are unaware that if they don’t use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the “list” price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.
So we canceled the surgery and started the scheduling process all over again, this time classifying my patient as a “self-pay” (or uninsured) patient. I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance.
Read the whole thing. The whole concept of health insurance has been so distorted most people don’t even know the meaning of it anymore. Think about it. Why is automobile insurance so cheap when compared to health insurance? Because auto insurance doesn’t cover routine maintenance like brakes and oil changes. If your car breaks down you don’t submit a claim to your insurance company. You only use auto insurance in the case of an accident. You might be covered under a warranty, but that’s built into the price of the car, and in most cases warranties don’t cover routine maintenance.
Politicians and their decades of social engineering brought us this distorted “health insurance” market, and then they decided to “fix” it by making it all worse. The answer is out there, but they all just choose to ignore it. Heaven forbid they tell people that human beings should be responsible for the maintenance and upkeep of their own bodies, and that health insurance should be there to cover the unexpected and catastrophic events that nobody can plan for.