A doctor who won't take any insurance or Medicare? Yank their license, plus imprisonment.

[Ms. Toad]

137. It is because of the negotiated fees with the insurance companies

Each provider that accepts a particular insurance has negotiated rates with that company which are substantially discounted from the billed rates. (More on that in a second). On labs the rates I'm seeing are typically 5-20% of what is billed. For doctors it is 80-90% of what is billed. So because you have insurance you get the benefit of the negotiated rates. It will take you longer - but you are getting credit for everything you actually pay.

As to the billed rates - because the insurance rate (and Medicaid or Medicare rates) don't always actually cover what it costs to provide the service, those added costs are generally tacked the bills for cash customers (so what everyone is billed is more than it costs for what you are provided - and the extra collected from cash customers makes up for the bulk of the business which doesn't pay for itself). Sometimes if you are a cash customer you can negotiate a lower rate with the provider. The one time I tried, the doctor refused to come anywhere near the insurance rate. My daughter needed jaw surgery. The doctor would have accepted around $2000 as payment in full from the insurance company - but it was a 2 year process (two surgeries), and he dropped the insurance company after the first surgery and before the second. We didn't want to switch doctors mid-procedure so we tried to negotiate - he would only drop from his billed rate of around $10,000 to around $6000. He considered the true cost of the procedure, and was willing to forego the extra $4000 he tacked on to make up for insurance etc. shortfall - but he was not willing to accept the insurance rate.

Fortunately we found another provider who was twice the surgeon the jerk was so it was actually the best thing that could have happened - but it was nerve wracking at the time.