what obummercare may do, is force and accelerate what needed to happen- for patients to work directly with their doctors and surgeons to arranged reasonably priced self-pay care. Case in point: we recently arranged and self-paid for my husband’s umbilical hernia surgery- initial new patient surgeon office visit ($200), surgeon fee for actual surgery ($300), surgical center ($1350), anesthesia ($300), and 2 followup surgeon visits(free). The best quote we got for hospital was around $4500 self-pay cash up front and that didn’t include surgeon or anything else. Rates were significantly higher if you had insurance, and of course it’s false to assume insurance “pays” as you pay premiums and deductibles and co-pays.
I have been thinking/saying that one of the “good” unintended consequences of Obamacare was that people would ‘just say no’ and start paying cash/negotiating with their doctors. The ‘something catastrophic happens’ issue aside, especially with the high premiums and deductibles under Obamacare, you pay and pay and pay on premiums .... then have to pay and pay again to meet deductibles and copays .... and still have no medical care that’s not out of pocket .... if you can find a doc/hospital to take the cr@ppy plans. If you accept a subsidy/tax credit & the calculation is wrong and the subsidy is too high or your income changes & lowers the amount or eliminates your eligibility, you could be getting a very hefty bill from the IRS to repay the subsidy & on this issue, they aren’t restricted to only refunds to collect. Those high premiums alone will pay for a good amount of medical care - direct with the doc where the two of you can decide what is best, no insurance company or government intrusion.