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How to Reduce Healthcare Costs by 92 Percent

With one thing and another, I hadn’t been to the doctor recently — looking for that affordable health insurance I’d been promised, working irregularly as a freelancer, that sort of thing — and I’d particularly been putting it off because I had thought, based on my bills when I had insurance, that it was gonna cost a fortune. But my doctor finally twisted my arm enough that I guessed I had to go and asked about the cash price for the labs I needed for a type 2 diabetes check. She thought it would be around $300, which was already much better than I’d expected.

So I went in to see her, and she got out the á la carte cash menu from the lab. We went for an A1c (long-term blood sugar, you can read about it here), a general blood workup, and urinalysis.

Total price, including $5 for the needle stick itself, was $62.

I was just a little surprised (read “flabbergasted”). The doctor visit was $163 because I had a longer than usual visit since it’d been a long time since my last one. So, my out-of-pocket cash outlay was $225.

Now, that didn’t even fit with what I’d been seeing on bills from the same clinic under insurance — plus, there was this annoying part where I’d get something done, and six months or a year later I’d get a call from a collection agency asking for their, I don’t know, some small amount, say $50 to $300 to be paid to some medical lab or medical service of which I’d never heard.

This led to some interesting conversations to the effect of:

“You owe our client money.”

“Who’s your client?”

“Acme Medical Providers,” or some such thing.

“Never heard of them.”

. . . until finally, it turns out that "Acme Medical" is some company that contracted with the lab at Boulder Community Health, which was the lab used by my family practice doc, who if they ever billed me at all, did so in a way that I didn’t recognize, since I’d never heard of them.

Between those calls and the insurance paperwork I did get, I knew these labs were very expensive, which is why I’d been putting things off.

So, I thought, “Sixty-two dollars? I’ve been worrying about sixty-two dollars?”

Then it occurred to me to ask, “What would the bill be to the insurance if I had insurance?” The nice nurse at the front desk — and I’m not giving her name on purpose — looked it up and told me: “$740.”

So, I’m not an accountant, but I do have a pretty decent math background, and applying only the tiniest bit of advanced math, I realized that meant they were giving me roughly a 92 percent discount for paying cash. Or, looking at it the other way, that the insurance company price was marked up roughly 1200 percent.