I hesitate to write this for the reason that I doubt that it is typical. However, I believe it may illustrate the cost of the Political complications of a government medical program, specifically Medicare and Obmacare. Perhaps others may be able to use some ideas.
My wife and I have a Medical Savings Account for our health insurance. It is a savings account that I initiated, through our accounting department, starting in 1961. I pay no insurance premiums.
This year my wife underwent knee replacement. Prior to the surgery and recovery, I visited the doctor, hospital and ReHab Center to discuss our payment system, informing them that since my wife was not covered under Medicare (she is in her 70's) and since we were prepared to pay cash for all costs, I wanted to negotiate the involved costs.
In our discussions it was pointed out that in our situation neither the doctor's staff, nor the hospital staff, or ReHab staff would be required to be involved in Medicare techicalities, Insurance Company requirements, or any government paperwork. Only a statement of amount would be provided to me at each step in the procedure and would pay upon receipt of the bill.
Two weeks ago I visited the Doctor and the hospital finance manager. My wife has completed all of her Rehab visits and all bills were paid by me. Both the Doctor and Hospital person informed me that by my paying cash for all costs, both doctor and hospital received more net income than they would have received had Medicare been involved. And, both informed me that the amount that I paid was less than most Supplement Insurance with Medicare premiums would have cost me. The difference, the amount discounted for cash, was that costs that the doctor and hospital did not have to endure with the details required with Medicare/Insurance.
It was just much simpler and cost effective for the doctor and hospital to just bill me personally rather complete all the record/paper work for complications. And they received payment without the delay at each step of the process. I just wrote the checks at each step at checkout with no delay for payment.
Actually this worked out just about like other purchases that I make for my business. By negotiating a cash price in advance, I usually save costs.
I do believe that even while we hear many complaints about insurance companies, if Health Insurance was permitted to be competitive, perhaps more like property, casualty, auto and other insurance, Medical Providers, Health Insurance Companies, and customers, all would realize savings and the system would be much more simple. I have always believed in the Principle, "KISS".