In fact, I paid cash for the birth of both of my children, mainly based on the fact that an honest agent told us we’d spend less by saving and paying in cash as opposed to paying the maternity rider premiums. When I registered with the hospital, I signed a contract where I received 35% off their ‘billed’ rates if I gave them a check within 30 days after discharge.

I have done the same with dental work as well. I told them I was ‘private pay’ and would right them a check for services rendered if they could cut me a deal. I had to call a couple different offices, but I easily found one that would deal. It must be that the quick cash in hand is so much better than the beaurocracy of payment from insurance.

On topic, I’m glad I don’t live in Mass. Wow.

So, effectively, one has to have health insurance.

Somehow, in my view, the US has managed to end up with the worst of all worlds in healthcare; it’s expensive, inefficient, effectively unavailable to too many people, and not all that great in terms of quality of service either.

Even socialised medicine would be better, scarily enough. Having grown up in a country (England) with socialised medicine, I know all too well its downsides, but the current US system does not seem to be any better – just badly done in a different way.

But this wouldn’t solve the problem either because, as alluded to above, providers are forced to raise their prices to the uninsured so that they can stay in business accepting the 50 to 90% discounts that the insurers insist on. A system that forces pre-discount prescription drug prices well above those that a monopoly supplier would charge in a free market is broken.

Regards, Don

On your example of the cancer detection test, let’s be fair. Let’s say that it can be covered by insurance for a $20 copay. You can be sure that the insurance companies are only paying $350 for that $1000 test. If you’re uninsured and you try to get the same test, though, the hospital will charge you $4000 for it.

Of course, governmental policies make it nearly impossible for individuals to obtain health insurance at reasonable rates, so they’re exacerbating the problem. But the insurance companies are able to contract lower-than-market rates for certain procedures as a group, and the hospitals make up the difference on the uninsured (or the government, sometimes)…