In Healthy Competition, Mike Tanner and I argue that when patients control the money involved, health care providers compete much more aggressively for those dollars on the basis of price, quality, and convenience.
Recently, American Public Media’s Dick Gordon conducted interesting interviews with patients of an Apex, North Carolina, doctor who accepts only cash. The doc posts prices for his services, which end up being affordable for his modest-income patients. For example:
- Office visit: $45
- Urine Test: $25
- Pap Smear: $55
- Cholesterol Check: $25
(How much does your doctor charge for these things? He probably gets most of his money from insurance companies, doesn’t he?)
Gordon, the doc, and the patients discuss the economics of primary care and what one patient called “the insurance racket.” The doc even offers some good advice on how other doctors can switch from an insurance-based to a cash-based practice.
Gordon then switches gears to interview an uninsured patient who had been in need of heart surgery and who said:
The hospital system in America and the insurance system in America place people who are self-pay at an extreme disadvantage.
U.S. hospitals had given him price quotes ranging from $70,000 to $200,000. However, Escorts Heart Institute And Research Centre in New Delhi (about which Tanner and I wrote in Healthy Competition) gave him a quote of about $10,000. Not only was he satisfied with his care there, he said he would go back “in a heartbeat.”