GunnerQ wrote a post on up-front pricing in medicine. I have found everything he says to be true. Even when I have asked for prices for various procedures, medical providers don’t know. The bill you receive for service (the price) reflects some average of all the people who pay and don’t pay for the same services and your demographic data which gives the likelihood you WILL pay for the bill you’re receiving. If you’re a married white man with a house, you’ll get a larger bill than the illegal immigrant from Mexico who claims he has no money despite all the welfare he gets from the state and the huge brand-new truck in the driveway of the house he shares with 10-20 other people. Medical prices are thus produced by a hospital computer algorithm rather than posted like every other service in every other business. Expect hospitals to fight price transparency tooth-and-nail.
Happily, there are several strategies to protect yourself from medical provider theft.
Strategy 1: Insurance
You can get the same benefits as health insurance (risk-pooling, contractual pricing for services) using Liberty Health Shares if you are a Christian. My friend uses this service and loves it and claims it’s very cheap. Regular health insurance companies are run for their executives and shareholders and executives get paid largely in company shares. Health insurance companies are not your friends but a necessary evil. They may be an unnecessary evil depending on their premiums and deductibles which are now in the realm of outrageous.
Strategy 2: Fight the bill
Check our Broken Health Care. The initial bill you receive from a hospital is for people dumb-enough to pay it. Never pay sticker price.
Strategy 3: Stiff ’em!
I’ve done this when the first 2 strategies failed or haven’t worked well-enough. Moralizers will tell you this is the WRONG THING TO DO since it involves NOT PAYING WHAT YOU OWE. However, the hospital is not charging you what you owe, but what you and Jose from south of the border owes. This is especially true for OB/GYN care which is why it’s outrageously expensive to have a baby: you’re also paying for Jose’s anchor baby. This is analogous to taking your car in for repairs and being expected to pay for someone-else’s car repair and yours. It’s absurd to suggest it’s unethical to pay only what you owe.
I’ve called hospital billing departments, told them I was going to pay what I thought the service was worth (usually 30-50% of the bill), and that they could send the rest to collections as I’d rather negotiate with a debt collector than them. Laws were recently changed to prevent medical bills from damaging your credit as much as it did in the past. Debt collectors buy debt from hospitals at 5 to 10 cents on the dollar, so if you offer them 15-20% of what you originally owed, they made 50% profit. This strategy can be riskier depending on the size of the bill since hospitals will probably sue you if you don’t pay a large bill. Still, it costs them to sue you and most lawsuits are settled before going to trial. The last thing a hospital wants is their billing exposed to a jury.
One final note. The Left is pushing for national, single-payer health care. They can push all they want but this idea didn’t even make it to a vote in the California legislature last year. We’re already spending close to a trillion in Medicare to cover 60 million people in the US. Try scaling that up to 330 million people and you can quickly see that we’d have to somehow treble tax revenues as our federal budget is $4 trillion. Medicare and Medicaid account for about 25% of our national budget. Cutting defense spending to zero still wouldn’t enable us to come close to paying for a single-payer system. You’re on your own! This is becoming more true in the twilight of the United States and even the post-Westphalian nation-state system. You’re going to have to stick up for yourself. Start with resisting lesser injustices such as medical bills and it becomes easier to resist greater ones.