It is a really weird mental block we have against paying out of pocket for medical bills, particularly since this is probably the most, not the least, important thing we can spend our money on. Having a high-deductible health insurance plan has been a real eye-opener for me. As in this post from Maggie's Farm, I too have found doctors will very often give a discount for cash. My son has a great sports medicine guy (he plays 3 varsity sports so we seem to be at the doctor a lot for one injury or another) who gives us a $40 cash rate for a visit. Further, when he needs X-rays, the radiology place downstairs usually does 2-3 films of the injured appendage du jour for around $35. The X-ray place has a special cash price book they pull out when I show up. I shudder to think what rate they charge insurance companies. And t just think of the piles of infrastructure from my doctors office to the insurance company to Washington DC that would have had to come into play had I sought 3rd party payments for these bills.
And when it comes to the expensive things, it is amazing what price cuts you can find with just a little shopping. Previously, I had spent less time in my whole life shopping medical care prices than I had price-shopping my last hard drive. But when my son had to get a CT scan on his head (yes, another sports injury) we saved hundreds of dollars just calling a second place for a quote. In fact, even mentioning that we were going to price shop the first quote got a few hundred dollars knocked off. The lack of any rigor in health care pricing is just appalling, and will only get worse as government / single payer solutions crowd out approaches like mine under Obamacare.