Any studies on how paying cash for medical care would lead to lower cost?

[Bastiat's The Law]

I agree with Rand Paul on this and I think most republicans/libertarians do at some gut level, but I know skeptical liberals will ask for data and numbers.

[acptulsa]

Typical starting wage for any clerical worker capable of completing Medicare or insurance forms in the poorest states in the union: $10.00 per hour.

[Ronulus]

Cuts out the middle man. How do you think they afford all those salaries for people working in medicare/medicaid/writing the laws/health insurance companies, etc. That is a lot of overhead. Cut all that out, give the money directly to the doctor or hospital. It is much cheaper.

Now one example I have is having my appendix removed. I told them I was going to pay cash and that I didn't have insurance. They listed the cost with insurance as being around 30,000$ yet without insurance it cost me like 5,000. Now if i had insurance I could have just paid the deductible, making it cheaper on me at that very moment (however would have still had to pay monthly etc and added up over the long term).

[Czolgosz]

Service or product delivery track record of price, quality, and quantity.


Government is, by and large, $#@!.

The free market is generally much better.

Neither is perfect, bulletproof, and unsusceptible to fraud. One uses force the other does not.



With the amount of variables in the equasion you can only speculate about the cost.

[Working Poor]

Once an insect flew into my ear and I could not get it out. I called several different emergency rooms and to find out how my they would charge to do so. I had no insurance 1 quoted me $1,500 the other $2,500 I then called a minor emergency clinic and they said they would remove it for $60 I asked them if they gave a discount for cash payment they said yes 30% so I paid $42 cash to have the insect removed and did not have to pay even one insurance premium which at the time would have cost me around $100 per month.

[tttppp]

I agree with Rand Paul on this and I think most republicans/libertarians do at some gut level, but I know skeptical liberals will ask for data and numbers.

Tell them to go to a doctor who only takes cash and compare to the ones who take insuranse. The difference is obvious. Most health care is affordable without insurance. Its insurance that makes it expensive.

[sailingaway]

Yes, but also every doctor who does it. My new doctor has an entirely different price structure for people who pay cash. It isn't controversial. Ron Paul has discussed this for a long time and gives examples of his practice, but I am pretty sure he has mentioned economists who have treatises on it, as well.

Here's a video Ron did in 2009 when Obamacare was under debate:

[Brian4Liberty]

Once an insect flew into my ear and I could not get it out. I called several different emergency rooms and to find out how my they would charge to do so. I had no insurance 1 quoted me $1,500 the other $2,500 I then called a minor emergency clinic and they said they would remove it for $60 I asked them if they gave a discount for cash payment they said yes 30% so I paid $42 cash to have the insect removed and did not have to pay even one insurance premium which at the time would have cost me around $100 per month.

That's a great example!

With insurance, they are taking money from everyone, and redistributing it to some. Why does that sound so familiar?

[opal]

uninsured...
hospital price for ankle xray 1150.00
(and they wanted us to stay and fill out finantial aid paperwork.. my reply.. just give me my prescription back)
independant xray lab 118.00
same lab with cash 92.00

[jay_dub]

My wife recently went to her OBGYN. She scheduled her for a mammogram and told her to pay cash as it would be cheaper than just her her co-pay would be if she used the insurance. The doctor herself does this to save money.

So there's at least one example of paying cash being MUCH cheaper than filing insurance.

On another forum this subject came up and a member that works in the field used a CAT scan as an example. In her area, the price was about $600 cash. Insurance costs were much more (over $2000) and Medicare costs topped even that (over $3000).

I'd love to see an actual study on cash vs private insurance vs Medicare charges. I'm sure costs vary by area and some procedures have more 'mark-up' than others, but from what I've heard, there is no real justification for the high cost of health care.

[sailingaway]

Now I'm wondering about something.

We have essentially 'major medical' insurance and just pay for other stuff. My doctor said that they HAD to charge insurance if we have it, by LAW (so we couldn't get the better rate.) Does that mean when Obamacare goes through completely and you HAVE to have insurance there will be no more reasonable healthcare because you won't be ABLE to pay for a cash and carry price?

[opal]

Now I'm wondering about something.

We have essentially 'major medical' insurance and just pay for other stuff. My doctor said that they HAD to charge insurance if we have it, by LAW (so we couldn't get the better rate.) Does that mean when Obamacare goes through completely and you HAVE to have insurance there will be no more reasonable healthcare because you won't be ABLE to pay for a cash and carry price?

I thought I saw a light bulb turn on in this thread

[Lucille]

My doctor said that they HAD to charge insurance if we have it, by LAW (so we couldn't get the better rate.) Does that mean when Obamacare goes through completely and you HAVE to have insurance there will be no more reasonable healthcare because you won't be ABLE to pay for a cash and carry price?

Dr. Rich warned about that coming but I had no idea it was in the bill.

Now that President Obama’s healthcare reform has become the law of the land, it is time for us to prepare ourselves for the real fight. Namely, will individual Americans ultimately be restrained, by law or by subterfuge, from using their own resources to pay for their own medical care? This notion is not as far-fetched as you might think. In this series of posts, DrRich explores this question, and demonstrates just how far we’ve already come in limiting the healthcare prerogatives of individuals.

Related: A John Galt Speech For Direct-Pay Practitioners

[Brian4Liberty]

uninsured...
hospital price for ankle xray 1150.00
(and they wanted us to stay and fill out finantial aid paperwork.. my reply.. just give me my prescription back)
independant xray lab 118.00
same lab with cash 92.00

Another good example.

I have found that many Dentists will not give you a "cash only" quote. It's possible that the insurance companies do sting operations to ensure that they don't lower prices for cash payers. Who knows...

[opal]

Another good example.

I have found that many Dentists will not give you a "cash only" quote. It's possible that the insurance companies do sting operations to ensure that they don't lower prices for cash payers. Who knows...

yeah.,. I really need to check into that. I have a tooth (root canal gone bad) that needs to come out and I have no interest in a bridge or implant.. just yank the sucker and send me on my way - nope.. don't need a pain med script (allergic to opiates) so motrin is my best friend. I think the other tooth I had just removed, circa 1985 costed about 35 bucks

[emazur]

Don't know if this is true or not, but I've heard hospitals would be very reluctant to offer a cash discount but privately owned practices are much more likely to do so

[tttppp]

Don't know if this is true or not, but I've heard hospitals would be very reluctant to offer a cash discount but privately owned practices are much more likely to do so

That's completely true. Hospitals will do everything to scam you and screw up your credit report if you don't have insurance. In private practice, most will give you a discount if you tell them you don't have insurance.

[Bastiat's The Law]

We should start a huge database of real life evidence.

[axiomata]

Might find what you are looking for in the archives of http://healthblog.ncpa.org/

[Anti Federalist]

Good examples all around.

I had to have a heart screening done to satisfy my company physical.

Even more frustrating is when they won't even take your money, as in this case.

I called all over, willing to pay cash, to do a standardized, common CT scan.

Nobody would touch me without talk of months long waiting lists, referrals and insurance.

The whole health care market is so skewed and lacking in any real marker forces and incentives that there is no realistic cost/benefit/need analysis going on.

Buying a damn house is easier than just going to the doctor and paying for service anymore.

[jay_dub]

Doing a search under 'cash vs insurance costs for medical services' gets a lot of info, but no real database of cash vs insurance costs. Though not geared specifically for cash payments, I did find a bluebook for many medical procedures that lists 'fair price'.

http://www.healthcarebluebook.com/pa...FairPrice.aspx

[opal]

health care ble book find
+rep
even has dental

[Brian4Liberty]

True story, just heard about it (albeit through the grapevine, a relative of a co-worker of a friend, not someone I know):

This woman was 38, and had no insurance. She was sick for a week, with a fever. She went to the local hospital Emergency Room, and they said, sure they would see her, if she paid cash (and like our other stories, it was an exorbitant amount). She couldn't pay it, so she went home. She got sicker, and went back, hoping they would reduce the price. No go, she went home. She died last weekend. They are saying the cause was septic shock (i.e. bacterial infection).

This is not to say that medical care guarantees a cure, no, far from that. But it is likely that antibiotics could have saved her. She should have gone to an inexpensive clinic the first time, but apparently a lot of people are under the impression that Hospital Emergency Rooms are the only option, and that they have to take you. Obviously, they will also hold you ransom.

[mike6623]

I mean, this sounds great, but not all people are able to just "pay cash" for such expensive things. It would be awesome if everyone had 5-10-20,000$ in cash to pay for medical services/surgery/medication....but we don't. I'm happy for you if you are sitting on tens of thousands of dollars to just hand over for surgery, but I don't...most don't.

I have ulceritive colitis, my colonoscopy with everything (when I had no insurance)=4,000 then 5,000 for remicaid, couldn't afford it, so they gave me a script...350$/month. I have a degree and only make 14$ an hour, I live in a low cost city in ohio, so for around here that is good, but in no way can I afford ANY of that...in cash.I don't want $#@! for free, and it is easy to spout off about...just pay cash! Yeah....unless you have money to wipe your ass with, there is no way most low to middle income earner with house payments, bills, etc can just fork out 10k in cash for hospital bills.

Be real

[dannno]

I mean, this sounds great, but not all people are able to just "pay cash" for such expensive things. It would be awesome if everyone had 5-10-20,000$ in cash to pay for medical services/surgery/medication....but we don't. I'm happy for you if you are sitting on tens of thousands of dollars to just hand over for surgery, but I don't...most don't.

I have ulceritive colitis, my colonoscopy with everything (when I had no insurance)=4,000 then 5,000 for remicaid, couldn't afford it, so they gave me a script...350$/month. I have a degree and only make 14$ an hour, I live in a low cost city in ohio, so for around here that is good, but in no way can I afford ANY of that...in cash.I don't want $#@! for free, and it is easy to spout off about...just pay cash! Yeah....unless you have money to wipe your ass with, there is no way most low to middle income earner with house payments, bills, etc can just fork out 10k in cash for hospital bills.

Be real

This isn't just about how an individual paying cash in the current market would lead to lower prices - This is about how if everybody paid for their own insurance or paid out of pocket for healthcare the prices would actually include a component of market competition so the price points can be properly set. Right now there is no incentive for a patient to visit a doctor with lower prices because it won't affect their copay, it will only affect everybody else's rates but on a tiny scale. Over a large number of people, rates will jump on a much larger scale.

So the treatments you are talking about that cost $5,000, which may only cost $150 to perform, might come down to $300 in price in a free market. Somebody with insurance might only have to pay half of that, somebody without insurance might pay the whole $300. But your employer will likely give you a raise because they aren't paying hundreds or thousands of dollars per employee to help cover their expensive company insurance.

[Bohner]

1) The government has been passing bill after bill that forces employers to cover more and more things via insurance over the years.
2) HC costs have raised dramatically over the years.

Coincidence?

[seraphson]

I agree with Rand Paul on this and I think most republicans/libertarians do at some gut level, but I know skeptical liberals will ask for data and numbers.

I think plain logical would work without the need of a study (but then again I see what you're up against).

I'm assuming by "paying cash" for medical care you mean covering routine visits with cash instead of having insurance cover it?
Well, does home owners insurance cover furnace filter changes? Roof changes? Routine four step lawn fertilization?
Does car insurance cover routine things like changing oil, batteries, tires, etc?

Why the hell is health insurance so special that it cover's routine things? It kind of defeats the entire purpose and definition of "insurance" since it's purpose is to hedge against an unlikely event (broken bone, finger cut off, serious trauma from a car accident, etc). It makes no sense to cover routine, completely expected events; that's not what insurance should do. And for good reason.

By having insurance "cover" everything including routine things you bid up the overall price of insurance since the medical service doesn't come out of thin air (aka magical neo-liberal unicorn land.) In addition we'd use a little more personal discretion of visiting the doctor since we'd have to pay for it. Hell, why have a routine "checkup" if you're feeling fine, especially if you're in your 20's, or 30's (it's been years for me personally)? By visiting the doctor less you provide less demand and hence lower prices. Simple Adam Smithian logic.

Now, there's the whole speal on the government subsidy (tax break) known as employer provided healthcare. Again, healthcare is once again held as something special. Why don't we have employer provide house, car, motorcycle, etc. insurance? It by no means should be, from a logical perspective, be held as "more important" since food is certainly way more important than health insurance (Don't believe me? See how long you can go without a doctor. See how long you can go without food. That was a fun experiment wasn't it!) By that faulty logic we should have employer provided food insurance to cover our grocery bills. Of course though if our grocery bills were completely covered what do you think would happen to the nearest grocery store? They'd certainly empty out a bit quicker since food is now nearly priced at zero since good ol' work's insurance "covers it". You'd eventually get higher prices, shortages, then rationing.

This argument is posted as though it was your counter party I was speaking to so I'm not directly addressing you since you mostly likely know some/all of this to an extent.

[Brian4Liberty]

1) The government has been passing bill after bill that forces employers to cover more and more things via insurance over the years.
2) HC costs have raised dramatically over the years.

Coincidence?

Great video. The part about shopping around is dead on. There's hardly any way to do it. If you hound them enough, they will tell you that "they base the price on industry charts".

[jay_dub]

This isn't just about how an individual paying cash in the current market would lead to lower prices - This is about how if everybody paid for their own insurance or paid out of pocket for healthcare the prices would actually include a component of market competition so the price points can be properly set. Right now there is no incentive for a patient to visit a doctor with lower prices because it won't affect their copay, it will only affect everybody else's rates but on a tiny scale. Over a large number of people, rates will jump on a much larger scale.

So the treatments you are talking about that cost $5,000, which may only cost $150 to perform, might come down to $300 in price in a free market. Somebody with insurance might only have to pay half of that, somebody without insurance might pay the whole $300. But your employer will likely give you a raise because they aren't paying hundreds or thousands of dollars per employee to help cover their expensive company insurance.

Agree with what you say except that higher prices do affect co-pay. Say you have a 20% co-pay. A thousand dollar procedure is $200 out of pocket. If that procedure was $300 for instance, the co-pay would be $60.

Our insurance has a high deductible so it takes a while before insurance even kicks in. If we pay cash for anything, it doesn't count against he deductible. The costs for this insurance goes up enough every year that it cancels out any pay raise and it's been that way for years. Couple that with the real inflation rate in the whole economy and it's easy to see that we're all losing ground.

[GeorgiaAvenger]

1-Cuts out the middleman.

2-Price negotiation and competition.