Why Being Uninsured Makes Sense for Many Americans

In a similar vein, I do surgery on patients whose insurance may not be contracted with my hospital or have no out-of-network benefits. For these patients, I negotiate a cash price with the hospital, that when paid in advance, represents a discount compared to what the insurance industry can get. The reason: Cash in hand now is better than a promise to get paid later. This is especially true since insurance companies are notorious for reneging on promises to pay and the costs (overhead) associated with billing and collecting from insurance companies is not insignificant.

One wonders, how much health care can be purchased for $6,400 cash? Paying in cash for health care may make more sense to some than using that money to pay an insurance premium.

For many Americans, the issue of making the analysis of whether to purchase health insurance is a moot point-they get it free as a benefit of their jobs. But if a choice must be made-which it is by many Americans who do not have health insurance through their job-many Americans with low net worth are probably making the financially rational decision to forgo health insurance.

References

1. Gianoli GJ. A myth of modern medicine: There are 40 million Americans with no access to health care. ENToday 2006;1(2):4-6.

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2. Himmelstein DU, Warren E, Thorne D, Woolhandler S. Market Watch: Illness and injury as contributors to bankruptcy. Health Affairs: The Policy Journal of the Health Sphere. February 2, 2005. Web exclusive. http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.63/DC1 .

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