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Comment by sputknick | Hacker News Reader

Agree with most of your points. These high deductible plans were supposed to encourage a "free market" approach to healthcare that would bring down costs, in that... "If I as the patient am paying out of pocket I will be responsible with the money". The problem is most doctors didn't get the memo, they continue with their pricing strategy, so that consumers of healthcare are not able to shop around. I don't mind if high deductible plans are the solution or if socialized medicine is the solution, as long as the end result is that health Care costs come down to what the rest of the developed world pays.

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We still don't have price transparency, so it's not surprising the customers of health don't shop around.

I went to a grocery store health clinic without insurance and asked how much it would cost to see the doctor.

They were surprised I asked how much it cost, since they just assumed my insurance would pay for it. After insisting, I finally was able to get them to look it up. They told me it would be $100, but during my exit (and payment) they increased the price to around $200 based on my diagnosis. I asked why it should cost me more money for the doctor to diagnose me with something else, when the doctor didn't do any other special tests (e.g. I wasn't paying for a medical test), and they said "That's just the way it works."

Every time I've paid out of pocket, I paid for the procedure ahead of time. I never considered it, but this is one of those good examples of why to do it.

Nothing stops them from sending you a bill after.

Each time I signed a form saying that I was paying for this service at the agreed cost. There was no open ended clause about paying them anything else which is usually signed when insurance is involved. So no you are in fact entirely wrong.

And you're in the US? Have never heard of that.

Yes.

And honestly it makes a lot of sense. The main point of those "we can charge you whatever forms" is because they often don't know off hand what their deal is with your specific insurance company and furthermore they don't necessarily know which people involved are in which network, etc. yet they just want to make sure that you are left holding the bag when the final bill comes due. But if there is no insurance company involved, they only need to decide what they will charge you and it's done. In that case, the open-ended contract is entirely unnecessary.

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