Good luck, I think cash payments may become illegal.
I doubt it. For all the fallout and protests the numbers of people who actually participate in that direct care market are not very high for several reasons. And I expect a national revolt on OCA within three years, and it will be aided by, I trust, the R's gaining enough Senate seats and holding on to the House to defund it. By 2015 there will be lots of empirical evidence and momentum to do so.
There's always the option of excellent and surprising affordable care in the Carribean and Thailand.