I wish I could say that for myself.

It's just the whole thing was extremely eye opening to me for a number of reasons. The first being how screwed people without insurance are from every direction.

Even though I know all about contracted rates and things like that, I'm just baffled that in the end, the lab is getting about 10 dollars. So the other 590 dollars just disappeared for all intents and purposes?

It's like a bunch of accountants dropped acid and did the math.

There is no solution short of single payor (or "socialized medicine" for those not spooked by words) that will fix the American health care clusterfuck.

there are Democrats who dont.

"Retail" price is always absurd, sky's the limit, lets-just-make-up-a-number crazy expensive.

Then insurance sees it and says no, here's what "reasonable and customary" for that procedure is, we'll say you charged that much and take it from there (deductible, co-pay...).

Point is, the job of the price is just to be higher than whatever "reasonable and customary" is so you get the maximum the insurance company will allow. There's no penalty for putting in an absurdly high price.

Of course, it's a big problem if you *don't* have insurance....

When I had my little widowmaker heart attack a decade ago, I went to the nearest hospital thinking I had gastrointestinal issues (thank goodness, I was alert enough to recognize something wasn't at all right and something was nagging at me that it could be something far worse).

The hospital basically said, "It appears you are having a heart attack". I'm like, "Well. Fuck." Then they tell me, we have to transfer you to a hospital two miles down the road because we don't have a cardiac surgeon on duty right now.

Of course, in the middle of having a heart attack, I was hardly thinking of anything other than "This hurts way less than it looks on TV" and "Crap. I could die."

They put me in an ambulance and drove me to hospital down the road.

I spent five days in the cardiac ward at the other hospital. I had to wear a portable heart monitor/defibrillator for a few months after that.

Hospital bill for 5 days in the hospital was about 200 dollars out of pocket, including sedation, surgery, stent placement, angioplasty and the nifty equipment rental for the monitor.

Ambulance ride two miles down the road from the first hospital costed me 1200 dollars out of pocket because the ambulance service was out of network.

No biggie, really, but I'm not sure that comparison shopping for ambulances is something people think about when they are having a heart attack. It still kinda irked me.

I was still arguing it was gastrointestinal issues as they were strapping me to the gurney for the ambulance ride. Was telling the doctor why I thought that, while he was trying to put the stent in, until he told me to be quiet.

The only time I ever had insurance as an adult was when I was a political appointee for a few years. I quickly married my longtime partner so he could have insurance, too. Good thing I did, because he had a cancer, caught early before it turned into a real problem.

whole amount, or as close as they can get, if you don’t have insurance. Sometimes uninsured can negotiate a lower payment and payment plan, but you have to practically beg to get it.

If all one can afford is a high deductible plan, it’s almost worth getting to protect yourself from rip-off charges ($600 in this case), far above what the provider routinely accepts from insurance.