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Comment by donatj | Hacker News Reader

Around 2012 before my wife and I were married, we both got pneumonia. I was insured through my employer, she was uninsured.

We went to urgent care at the same time on the same day, saw the same doctor and got prescribed the same drugs.

About a month later when the bills came, her bill with no insurance was somewhere in the $160 range. My bill after insurance was nearly $300.

I'm still peaved about this.

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Did you have a HDHP (high deductible plan)? In that case, you have no co-pay or anything until your deductible is used up. Employers typically contribute a good amount towards this deductible (or even more than) using an HSA.

It's still crazy that the bills were so completely divergent.

That's not the point. Your explanation is exactly what the issue is. Why is cash price cheaper than insurance price ? And in that case, why do we even need insurance for most of these visits.

In my view, the amount you pay for stuff before you hit your deductible is just another type of premium. If the cash prices you can pay for what you reasonably think your care will be in a year are less than your deductible, then it can save you a little money to do that. If you happen to be wrong, you'll have still have to pay for your deductible.

I pay for a specific medication OOP with goodrx because it's not covered by my insurance, and paying for it through them would be nutty ($1600/year versus $90/year). But other things I just lump in b/c I use a fair bit of insurance every year.

I think the problem is, it's insurance. I pay $1200/month for my ACA insurance as I am a freelancer. Those with full time jobs pay a similar amount, just indirectly. In a given year, if I am healthy and need minimal medical care, then my insurance puts me way behind financially. If I have a sudden medical emergency, it can really save me. That is of course, assuming the insurance company will honor their end of the bargain which is another matter altogether.

I don't want health insurance. I want health care.

Make no mistake, I think the entire health insurance industry is a meat grinder for profits and we should move to single-payer like most other affluent countries.

Was there any difference in ability to sue the provider in case things went wrong?

I heard that sometimes they ask the uninsured to sign away the ability to sue the doctor and get lower prices in return. I am not too sure about details, this is just hearsay.

I remember she did have to sign a lot of paperwork. I have no idea what it contained however.

And that’s because the product you were buying had a completely inelastic demand. You might have died if you didn’t get treatment.

Perhaps allowing healthcare providers to incentivize things like this is… not great? Because we’ll sign pretty much anything if we’re sick enough.

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