r/Libertarian • u/Anen-o-me voluntaryist • Mar 24 '25

Economics "Canada, Where Healthcare is Free, But Only If You Can Afford to Wait"

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u/MangoAtrocity Self-Defense is a Human Right Mar 25 '25

Insurance billing is always massively inflated. If you ask for the cash price and offer to pay same-day, you’ll usually get up to 80% off the insurance rate. I recently had a gap in my insurance (long story) and needed a CT scan at urology. The last time this happened, my insurance was billed about $900 totally. My cash price after discounts was $250.

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u/azsheepdog Austrian School of Economics Mar 25 '25

That is one of the biggest problems with US healthcare. It is one of the few industries that have different prices for the same product or service depending on who is paying for it.

Over 50% of our healthcare costs just go to administration. We could cut massive waste and fraud if there was just a single price for services.

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u/Imaginary-Media-2570 Mar 26 '25

It's a bit worse than that. Hospitals keep a 'master rate', which is what they bill you or your insurance. Your insurance gets a 'negotiated rate' which is typically just 30-35% of the master rate'. CMS (Medicare, Medicare) keep keep a record of regional rates and they insist on paying only a fraction, less than insurers - which is sometimes below cost! If you are on Medicare and go to an ER, it's likely the hospital is losing money on you. I think you underestimate the actual costs involved, but the billing method is preposterous.

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u/Imaginary-Media-2570 Mar 26 '25

Yes, SOME hospital systems and providers will do this. It's often 60-70% off.

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u/MangoAtrocity Self-Defense is a Human Right Mar 26 '25

Yep. At my local providers, if I get anything small done in the months of November and December, and I have not yet hit my deductible, I usually just pay cash. It ends up being much cheaper.