Skip to comments.Patients negotiate for care with cash
Posted on 08/28/2012 2:15:52 AM PDT by Cincinatus' Wife
Palo Alto resident Ed Lee routinely negotiates for his own health care services, everything from the cost of a scan to an urgent-care visit - often securing discounts of 30 to 50 percent off the original charges.
Lee,61, a self-employed public relations expert in the semiconductor industry, started bypassing his health insurance and paying out of pocket last year when he realized that premiums and deductibles were costing him more than $12,000 before his insurer paid a dime.
....Lee became part of a new breed of health care consumer - people who pay such a large portion of their health costs that they're questioning the value of insurance. And because they're footing so much of the bill, they feel they owe it to themselves to get a decent price.
Sometimes that means shopping around for prices for blood work or offering to pay cash for a procedure in exchange for a discount.
...."The worst they can say if you ask is 'no,' "said Lee, who has bargained for better prices at times than what his insurer could get.
"Every time I've asked," he said, "I've gotten some sort of discount."
Patients, especially those covered by their employers' health plans, used to be sheltered from much of the costs of health care because they paid little more than a co-payment.
...more employers are shifting toward high-deductible policies or requiring employees to pay a percentage of each health service they receive...an increasing number of self-insured consumers find they can afford little more than catastrophic coverage.
"We're on the cusp of a very significant transition to consumers being very concerned about costs," said Dr.John Santa,......
.......Insurers and employers are shifting an increasing share of costs to consumers leading up to 2014, when the industry will undergo major changes under the federal health law....
(Excerpt) Read more at sfgate.com ...
But for now (on page 2 in the article) Tips on negotiating for health care
This illustrates how the Ryan plan, premium support, would put market forces to bear to reduce costs.
thanks for posting..
Third party pay: the monstrous, deep taproot growing this mess, along with lawsuit abuse.
Make sure the recommended services are actually necessary: You don't want to short-change your health, but you also don't want to undergo needless treatment.I once saved a hundred bucks by asking the intake nurse: "Is it ok if I wait until after I see the doctor to take the X-ray?"
It was ok and the Doc said no need to x-ray.
Another time, I was told I needed to schedule a follow up visit to get the results of a certain test. This visit would cost $125. I asked if the doctor or his staff could call me with the results. "Yes." Cost for this? Zero.
It's amazing how much waste is built into the process. I think a large part of that is because, in most cases, there is no price pressure because the consumer is not the payer.
I'm not going to get this exactly right, but Milton Friedman talks about different types of choice and market transactions.
The first is when you choose something for yourself paying with your own money. The next is when you choose something for someone else paying with your own money.
The absolute worst situation is when someone chooses something for someone else with yet another person's money. The chooser has no monetary interest whatsoever in the choice.
It’s like all payroll deductions — your money goes out the door unnoticed. Eventually, the idea that your paycheck is their personal piggy bank becomes real. And there is no accountability — the less you know, the better for them.
“Proprietary pricing,” the price your insurance company negotiated on your behalf, yet you don't know how much if any of that price was “fair,” according to market standards. In many cases you are simply told to pay some odd percentage and a high deductible ....on top of your high insurance rate.
“But Jan Emerson-Shea, spokesman for the California Hospital Association, said patients simply can't bargain for hospital prices like they would for a car.” Well why the heck not Jan? Why can't I negotiate prices for medical care. The paragraph above clearly shows the disparity in pricing between service providers. As the ultimate consumer of said service, why should I not have the ability to negotiate?
I do understand Lee's position. It is one I hold myself...$12,000 a year for coverage that never seems to pay anything. Over the course of 5 years that is $60,000. That money invested...even more. So, suddenly there is an emergency? There's a good chunk of change sitting there for that rainy day. Over the course of 10 years with no major incidents...there will be more than double that. Again, how much is a catastrophic emergency?
They use the catastrophic emergency to scare consumers and then you buy policies with all the bell's & whistles. Under 0bamacare you can't buy just catastrophic coverage,...which oddly enough is the cheapest coverage to get!!!
Personally I think the best way to bring healthcare costs back into line is for people to drop and the bells & whistles coverages. The only insurance that should be offered is catastrophic.
It’s amazing how much waste is built into the process. I think a large part of that is because, in most cases, there is no price pressure because the consumer is not the payer.
You are being very gracious. I tend to believe that much of the waste is intentional.
I’ve been turned down every time I’ve asked for a discount for paying cash, from multiple practitioners.
I do the same thing.
Not worth the cost.
Just pay the Dr and Dentist and I save thousands per year.
I’ll get insurance in a few years when I think the time is right as I get older.
Here’s a site mentioned in the article.
How Many Chickens
A few months ago I offered to pay cash for a doctor’s office visit in an attempt to negotiate the best price. I do have a high-deductible plan and HSA.
I was told no, that if I had insurance the visit had to be billed to the insurance company.
If I paid cash, the amount end-to-end processing and paperwork would be negligible. It would have saved my doctor’s office time and money (at least to me it would seem it would).
It’s amazing how much waste is built into the process.
Ask the lawyers why that is. If a doc doesn’t order a certain test, and it ends up that test SHOULD have been ordered to rule out a specific disorder, the doc is going to get sued.
Doctors can’t win in our litigious society.
A small accident can end up costing you 80thousand in hospital bills. Its a good idea to have catastrophic insurance.
My boss went to the doctor the other day and his portion AFTER medicare was $150.
He later called the same doctors office and asked how much for the same visit if he had no insurance and paid cash. They said $70.
The key is to tell them you don’t have insurance.
I pay $1,800 a year for catastrophic insurance. It pays 100% over $5,000. p/yr.
Do the math if you don’t visit the doctor every week.
Again, how much is a catastrophic emergency?
I had a heart cath. In the hospital less than 8 hours. Hospital bill....$17,000 plus. My wife spent three days in the hospital which included the weekend. One CT scan, nothing else, Hospital bill $14,000 plus. Neither cost included the doctors.
Catastrophic emergency? No Just Catastrophic expenses.
And those amounts taken out of your savings for a rainy day...5yrs. = $60,000. Still not catastrophic enough to justify paying $12,000 a year for health insurance....
I haven’t had health insurance for several years. If i really need to go to the doctor, I go, and pay out of pocket. I pay for my RX’s out of pocket and get a 20% discount because I pay for them on the spot, and the pharmacy doesn’t have to do any “paperwork” or wait for their money.
If I crash in the car, I will pay from either my or the other car’s insurance, depending upon who is at fault.
Same thing with the Harley, although I will probably be dead from that one and it will be a moot question.
Catastrophic Illness? Long term Care? THOSE aren’t covered by conventional health insurance policies so I will cross THAT bridge when and IF I get to it.
So instead of paying $12,000+ a year on premiums + co-payments, I spend about $1200.00 a year on Rx and the occasional doctor visit.
Healthcare “Insurance” is a scam.
Ask the lawyers why that is. If a doc doesnt order a certain test..
It's certain that this is a major cost factor, and it also increases cost due to high liability insurance.
We know ways to dramatically reduce insurance/healthcare costs: Tort reform, free market solutions: removing state insurance regulations to require coverage buyer doesn't need; allowing competition across state lines; and going to something like a premium support system in the case of medicare.
It's so frustrating to watch government head in the exact wrong way.