Quote:I somewhat agree with you regarding how the cost has gone up, but let's be clear about it.  I went in for a physical a couple of years ago and paid cash.  It cost me roughly $60, and that was for a complete physical.  Now getting blood work done at a lab cost a bit more, but it wasn't an outrageous amount.

 

The basic way that it works as an example for a physical... if you have "insurance" you pay your $10 co-pay or whatever, then the doctor's office bills the insurance company $125.  People will immediately blame the doctors for "milking the insurance company", but that's not the case.  The doctor's office staff has to get paid for their time dealing with the insurance company.  The insurance company has to pay their staff, and so on...  Both the doctor's office and the insurance company have to make their money as well so something that costs $60 more than doubles if "insurance" is involved.  That's why if you have "insurance" a pill might cost $50.  If you pay cash that pill might cost $10 or less.

 

Here is another way to look at it.  You're a mechanic.  Say 1 hour of your shop time is $60.  A customer comes in for a routine tune-up, and it takes you an hour or less, you bill the customer for 1 hour of shop time.  The customer pays you in cash and you can immediately deposit that money into your bank account.  However, say the customer has "insurance" or a "maintenance plan".  In order for you to fill out the paperwork, contact the "insurance" company and wait a couple of days to get your money, well that costs you time and so that's why you bill the "insurance" company more money.

 

It hasn't been my experience the prescription is cheaper if I'm paying cash. I'll give a personal example, when we had no insurance my wife had a thyroid problem, I paid the $150 for her visit, but when the doctor prescribed all these "test" to find the source of her problem it was going to cost north of $2,000. The visit she prescribed some medicine for the symptoms she was experiencing in the mean time, when I went to the pharmacy they told us the prescription was over $200 for a 30-day supply. 

 

Now the why it cost so much that's a complex issue to which I don't claim to have the knowledge, I'm just saying in theory I'd love to say we don't need insurance for routine medicine but if that's the case we have to figure out why the cost our so far beyond the ability of the average consumer to pay.

 

Actually there is a system where at a mechanic shop I deal with something like the "insurance" company's it's when we have fleet accounts for national fleet managements. I end up billing them probably 2/3rds less than what an average consumer pays because they have negotiated prices in order for my company or any company to provide them with services. Now that might reflect in some of the cost that is passed onto everyone else which maybe that's why in my experience "Cash" customers without insurance are hit with such high cost in order for them to recover lower negotiated services provided to insured customers? 

 

To me the insurance companies are the biggest problem, anytime you have a middle man be it the government or private parties cost go up across the board. That's why the idea of Obamacare drives me so crazy, instead of finding a way to create a system where we can eliminate or significantly reduce the roll of the middle man, we made it IMPOSSIBLE to cut out the middle man.

 

Imagine if everyone was required to hire a fleet management company before they brought me a car to fix. It would take twice as long to get anything done and now you're paying twice the amount of people to do the same job, the employees of the fleet company negotiating products and services and the employees of my company performing the product and services. 

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