Recently, I was delighted to receive a copy of “The Self-Pay Patient” by Sean Parnell.
He has a blog of the same name, and he asked me to read his recently-published book and give him some feedback. (Full disclosure—the book was gratis.) I was happy to oblige; what he didn’t know was that I had been following his blog for several months and was eager to read the book!
Sean has a background in economics, writing and health care policy. He realizes, as I do, that today’s health care (and health insurance) is increasingly unaffordable for many.
He also recognizes that our health care and personal health decisions are being controlled more and more by insurance conglomerates and big government, what he calls “bureaucratic medicine.”
The new mandates and regulations of health care reform—Obamacare—are making health care and insurance more expensive for many, and creating more red tape for everyone—patients, doctors, hospitals, employers and insurance companies alike.
For the young, insurance may seem like a bad deal that asks them to pay inflated prices for insurance that delivers few benefits. Others will find insurance is still unaffordable, and more will simply reject participation in what I call bureaucratic medicine and opt to escape Obamacare and become self-pay patients, who pay directly for most or all of their healthcare.
Tens of millions more Americans will find themselves in high-deductible plans that require them to pay up to $5,000 or more for healthcare out of their own pockets before they begin to receive many benefits.
My new deductible is $12,000—what’s yours?
This book is for Americans who are or will become self-pay patients, and it provides detailed information explaining how by paying cash for most medical services and finding alternative ways of funding and paying for major medical expenses they can get the healthcare services and financial security they need, often at a fraction of the cost of traditional health insurance. As a result of becoming a self-pay patient, they can escape bureaucratic medicine. [my emphasis]
Pay cash and save money? Tell me more!
Finding affordable alternatives
It’s not easy. Mainstream insurance companies and government-funded insurance plans dominate the industry. They depend on you staying out of their dealings with the providers, and meekly paying your premiums and co-pays and deductibles (or whatever else they say you owe).
But luckily for us Mr. Parnell has done a great job researching alternative funding and cash payment options, and has put that wealth of information into a concise, clearly-written reference book.
Options explained in his book include:
- Healthcare Sharing Ministries
- Critical Illness, Fixed Benefit and Accident Insurance
- Short-term Health Insurance
- Cash-only or Cash-friendly Medical Practices
- Direct-pay or Concierge Medical Practices
- Online Shopping and Bidding
- Medical Tourism
- Public and Private Charity Care
He also provides resources for finding discounts on prescription drugs, lab and x-ray services, mental health services, dental and vision care, and for negotiating cash discounts or lowering bills with hospitals and surgery centers.
Such an array of options can be confusing. At the end of the book, however, he runs through several common (although fictional) scenarios that help demonstrate how the different funding sources and discounts can be used together to save a family money.
The self-pay movement
Over the last few years, there has been a growing grassroots movement of providers who want to reduce or eliminate the bureaucratic hassles associated with insurance companies and big government.
They don’t want to waste their time collecting “meaningful use” data on every patient, and wait 90 days or more for pennies-on-the-dollar reimbursements. They don’t want to be told how to practice medicine and do what’s best for their patients. They know.
As Mr. Parnell points out in his book, most of the new cash practices are in primary care. Primary care doctors are the lowest paid of all physicians, because they mostly “talk”, and talking isn’t worth much to the insurance companies.
But most of the care we want and need is primary care, so those without insurance or those with super high deductibles (like me) might really benefit from this cash-up-front trend.
I don’t have dental or vision coverage, so my family has done cash business for years with dentists and optometrists. Their prices are readily available (transparent) and I can be a frugal consumer and compare cost and quality of service before making my choice.
Unless my family experiences a medical catastrophe, we are never going to come close to meeting our $12,000 deductible. I would welcome the opportunity to work directly with a physician and pay a fair cash price for services.
I hope more providers and patients break free from the behemoth of our modern health care industry with its perverse incentives that keep us using more and more health care without knowledge of the cost (or risk, in some cases). Then perhaps we will see true health care reform with increased choice and accessibility, transparent and fair prices, and good, old-fashioned patient-doctor relationships.
Thanks for writing this book, Sean! It’s a much-needed guidepost in the wilderness.