This isn’t really a cash-only like thing. If you have catastophic insurance, you still deal with network providers-or pay more because all your medical expenses won’t count toward your deductable-and you still have to file claims so the insurance company knows when you meet that catastrophic level.

Depending on your health profile, it might be better to have a catastrophic plan-but you still have to pay premiums and this will still cost more than the office visits. So much for $300 a year.

So to compare $300 a year for not having health insurance with $3600 isn’t based in reality.

In Illinois, uninsured hospital patients no longer have to pay list price – enough hospitals got taken to court for overly aggressive collection practices against uninsured patients and lost. AG Lisa Madigan finally got the Fair Billing Act passed – it’s x percent off list (varies by hospital/chain), so true price transparency is not available.

Then there’s the problem of Rx drug pricing for chronic illnesses. Drug prices are so inflated and distorted (if your condition falls outside the Walmart $4 range).

I see my PCP once a year (pap and TSH); the pulmonologist twice a year (spirometry once annually).

It’s not the dr visits that are killing me, it’s the Rx prices and the high premiums of the state high-risk pool that have me over the barrel.

It’s not either-or. You can have an HSA account, pay cash to go to the doctor of your choice, AND have the HSA cover you for catastrophes. It is the routine use of insurance for routine care that is the strange thing about our system. Its akin to using your home insurance to pay for a maid to clean it!

Also, for physicians who do accept insurance, the HSAs can use negotiated pricing – so you don’t pay that very high price the man off the street will typically be charged.

Actually dropping insurance works out pretty well for some people–and I don’t mean deadbeats who don’t pay their bills. It is a risk that can pay off. A great many small successful small businesses that create jobs and wealth were started by someone who could afford to do so only by taking a range of risks including going uninsured initially.

It only become a financial catastrophe in the event of medical catastrophe. Even the occasional large expense may be less than the huge insurance premiums that are paid.

I know someone who, against my advice, went bare for 20 years. Finally life-threatening illness struck-there was a hospitalization, procedures, and a huge bill–but it was still less than 2 years worth of my insurance premiums. He simply wrote a check without even trying to negotiate the exorbitant “self-pay” prices from the hospital, and noted how far ahead he was.

Health insurance coverage is a choice that people should be free to make or not according to their own personal risk tolerance and means, not forced on them as a universal good. Doctors and hospitals should charge cash patients fair rates that reflect a realistic correlation with the value of their labor reflected in the rates that they accept in negotiation with other payers

The fair thing would be to charge everybody the same fees and reject contracts with third party payers who interfere with that.

So yeah, cash medical practices are limited. Why would I go to a cash only practice when my health plan already provides me coverage for standard office visits? I cannot “save money” by paying $300 versus $20, and I’m not sure how Kevin gets to that math (unless I give up my health insurance premium).

I am tired of Chuck Brooks saying we “consumers” are too lazy and stupid to make decision on cost. I look at every bill. It is so difficult for me to find out what something will cost. At least retail clinics are making prices transparent.

I just saw a PA in my providers office-$300. Plus the money I paid for the blood draw, the money I paid for the lab work, plus the money I paid for the imaging. I am in for over $1000 and I haven’t even begun my treatment. The 6 day supply of medicine was over $500.

My insurance covers this and the next episode and protects me from some catastrophic episode for only $3600. And it’s not because I want to feel my healtcare is “free.”

When people start paying more out of pocket for their healthcare, they will be much better educated about their health and how they are being treated by their provider.

That said, my company does not offer great dental insurance, except for routine cleanings and x-rays. I have paid cash (not credit) for all other services and it works fine.

Your reward for cash payment is a larger bill.

“Cash only” visits, and labs are billed at a higher rate too by most practices.

IF medical savings accounts for office visits and labs were discounted as they are for insurers.

If I had to pay what my insurer pays for care, I’d gladly lose the insurer for minor illness and routine visits.