One of my pet peeves is that health care in this country is so outrageously expensive precisely because most people (wisely) have health insurance.

If Obamacare can be defeated, we might be able to have a genuine discussion about such issues and come up with real ways to reform the system. As somebody who’d been around policy types for years, I know that there are lots of intriguing ideas out there. We need to kick around some of the ideas rather than ram a massive takeover of health care through Congress with widespread public anxiety.

But back to my original point: Kent Holtorf, M.D., had an excellent piece in Forbes the other day, suggests that focusing on expanding our current health insurance system might be the wrong way to think:


A major problem with the current insurance model is that it does not work for services used on a routine basis. Insurance is designed to work for services that are unexpected; it is a very poor and ineffective method of delivery for routine, expected services.”

Holtorf explores medical savings accounts—which haven’t even been considered in the current debate—but he makes a really revolutionary proposal:

“An even more significant change would be converting to payment on a cash basis. We have found that, almost without exception, laboratories, doctors and other services will happily take 70% less if paid in cash at the time of service. Their costs are increased by that much if they have to bill insurance companies and incur other expenses–plus the risk of denial–in an effort to obtain payment which, if approved, generally arrives 30 to 300 days after initial billing. For instance, we have contracts with the major laboratories at 70% less than what they bill insurance companies. CT scans and MRIs, usually billed $2,500 to $3,000 to insurers, are contracted at a rate of $165; colonoscopies that doctors bill at $1,500 are done for $400. The cost savings are not in the care but rather the system.”

Paying your own doctor’s bills may sound scary—but it would probably save you money.

Here’s an idea: Defeat Obamacare so that we can have real healthcare reform.