This is one of the worst parts of USA healthcare -- why are uninsured patients charged more than insured patients? (sometimes much more, like 10 times more [1])
[1] https://www.washingtonpost.com/national/health-science/why-s...
(Having said that, I don't think the pathological cost divergences in US healthcare are mostly explained by this)
Which means you need the big guns (health insurance company or your own millions for legal fees) on your side, or else be destitute and have nothing for them to go after. But if you’re in that sweet spot where they can make up a bill since you signed a paper that says you’ll pay whatever you need to keep you alive, then you’re screwed.
And unlike, say, choosing between buying a $250k Lamborghini vs a $20k Toyota, the patient has to choose the $250k bypass surgery or he'll die. Which is why this can't fairly be judged purely in business terms, customers have little choice in whether or not they purchase healthcare services.
Because I’m not a sociopath, and I don’t think of healthcare as a product just like kitcat bars, and I don’t think a civilized country should allow this to happen.
The moment you accept framing it like people are buying and selling kitcat bars, you accept misery and death that are completely avoidable in economically advanced countries.
"Wait, you mean I pay nearly $5000 a year for healthcare insurance, but they won't pay for healthcare until I reach a $5000 deductible!? And if I don't ask each and every doctor at the hospital if they take my insurance, they may not be covered at all?"
...
...
...in our Toronto office.
That's one way to discover a giant out-of-network bill, when you went in for surgery at an in-network hospital, performed by an in-network surgeon, with an in-network anesthesiologist... And an out-of-network nurse, whose job consists of holding the saline bag for 30 minutes, at ten times the billed-to-patient rate of anyone else in the operating room.
I wish I was kidding.
I wonder if our attorney could prepare a contract that stipulates no out-of-network interaction without authorization. But who would we get to sign it?
You're not describing health insurance firms here. They constantly innovate new reasons to delay, diminish, and forget about payments to providers. For small procedures, many providers charge cash patients less because they know they'll get paid when the service is provided. They do this even though it often violates contracts they've signed with insurance firms.