“But there are a LOT of medical procedures that the average person can’t afford to pay cash for. Labwork, surgical procedures (even minor ones), and some imaging are more than people can come up with on a regular basis. Many people have medical problems that need care constantly and paying for it is just not possible. This is especially true of old people who have a constellation of problems.”
I disagree. I just went in for a battery of tests, and the bill was right around $420. As it happens, my insurance was cancelled about a year and a half ago. Not related to 0’care, related to...never mind. I suppose I could have spent $592 a month times 18 which is $10,656. Or, I could have spent $420. which was a 30% discount for cash.
You or I can go to the Oklahoma Surgical Center and pay approximately 1/5th of nominal rates for surgical procedures. They do not take insurance. They take cash money. There are 2 takeaways from this.
One is: The medicare co-pay is 20%. One fifth. If you are a medicare patient and go in for surgery, you will be charged 20% of the total as your co-pay. Now think very carefully: What the hell difference does it make whether I pay the 20% to medicare or to the OK Surgical Center? Answer: Absolutely nothing. Question what do you get for medicare? Answer NOTHING.
Now there are a lot of people who can not come up with $50K cash on the spot but arguably, those who can, are in many cases older people. That’s not the point. People go into debt ALL THE TIME for gambling, stock market losses, harebrained business ideas. Peopl take on $50K in debt all the time, and it’s irritating, it’s a pin in the butt, but they do it, and maybe they take a few years to pay it off but it is not life-ruining, it is not the end of the world.
You may work at a doc’s office and have an insight into what it takes to operate such a business with the attendant overhead. But your view of that is absolutely skewed, and I say that without reservation, by the compensation rates for insured medical care. I saw this in my Mom’s last year, when she needed all manner of medical care. Procedures that were billed at $1327 and paid out at $58. Billed at $732 and paid out at $37.62.
The fact of the matter is that nobody works for free. When you add an insurance company into the picture, they must be compensated. When you add the overhead into the doctor’s infrastructure, the person or persons who do that clerical work must be paid, and the delay in receipt of payment from the various ins companies must be taken into account.
I recommend you view this:
http://www.youtube.com/watch?v=r9q1Id41wGo
The second takeawy from the OK Surgical Ctr is: Healthcare costs are 5 to 10 times their real world costs. And the system is designed to preserve this gouging, primarily by the insurance companies. never mind the incredible assault on liberty and personal freedoms implied and mandated by 0’care, as long as this is the case and the free market is foiled, there is no solution other the egregious cost shifting we have seen.
I’ve heard it suggested that for advanced medical procedures you could pay into a regional Hospital/clinic system where they would charge a monthly or annual fee, insurance companies would be eliminated so the fees would be much cheaper. This would cover you for catastrophic illnesses or serious injuries. You could choose the best system in your area for competition. Basic visits to your family doctor would be paid in cash, or you could pay your doctor a similar monthly fee to cover minor illnesses. All much cheaper than insurance. Your thoughts?