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Back in late '16, we pointed out that "going bare" had begun to make sense since health insurance had become too expensive to use:

"It might be a ticket to get you into certain medical facilities, but in these days of narrow networks, it will keep you out of others."

Believe it or not, it's gotten worse:

"Obamacare is now so expensive it keeps patients away from their doctors"

And, I would add, their hospitals and specialists, as well.

As Heartland Institute's Justin Haskins points out:

"In a recent survey ... 47 percent of those surveyed said they chose within the past 12 months not to see a doctor or dentist for a routine checkup ... because of the high costs associated with healthcare."

But how could that be; after all, annual physicals are "free."

Well, except for that whole pesky thousands-of-premium-dollars-later thing.

And then there are the non-routine costs, with additional out-of-pockets in the thousands (often tens of thousands) of dollars.

The point, of course, is that the ultimate end-goal of ObamaCare has always been  Single Payer; by that metric, these unworldly prices are features, not bugs.

Definitely click through to read the whole thing.

[Hat Tip: FoIB David Fluker]

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Back in Aught Nine, we noted that "[a] group in British Columbia has offered medical waiting-list insurance to members whose government treatment is on hold."

Well, turns out that the folks in charge of Canadian health "care" haven't taken too keenly to these kinds of work-arounds:

"The B.C. government has moved against doctors who engage in illegal extra billing, enacting a law that aims to end queue-jumping by patients who pay to fast-track access to publicly funded medical care."

What makes this so funny ironic is that the province leads the country in these types of practices.

For now.

Which may be good news for American providers, no?

[Hat Tip: Sally Pipes]

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Almost exactly a month ago, we reported on the Much Vaunted National Health Service©'s latest infanticide effort:

"Alfie Evans, a 21-month old Brit, has been fighting hard for his young life. But the Powers That Be at the MVNHS© are (literally) pulling his plug"

Now comes word that thanks (at least in part) to Pope Francis, he's been given a reprieve:

"Alfie Evans’ Life Support Won’t be Switched Off, Delayed After Pope Francis Intervenes on His Behalf"

Keep in mind, of course, that the MVNHS© has ultimate authority in these cases, even when the parents offer to pay for his care outside the system.

Let that sink in, Single Payer advocates.

[Hat Tip: FoIB Moxie Mom]

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We've talked about transparency, Direct Primary Care, and other strategies to try to rein in health care costs. But this item, tipped to us by FoIB Holly R, may just be the most effective method yet:

"Need a medical procedure? Pick the right provider and get cash back"

Most of us are likely familiar with the "Find a Provider" button on our carrier's website, or a referral from one's Primary Care doc, and these can indeed be money savers. But until now, I'd never heard of a plan that actually pays you cash on the barrel-head to choose a specific facility.

Now, there's always the question of quality vs cost, and that's a valid concern. But one would think that negative feedback about any given provider would be taken into consideration buy the insurer (or not).

Nice to see more outside-the-bun thinking.

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■ We've made the case that "going bare" can certainly be a rational choice:

"There are necessities of life, but insurance is not one of them."

But what' s it actually like making (and living with) that choice?

Well, FoIB Bill M points us to this rather interesting (and, I must say, relatively balanced) article on just that:

"While these people are among [those] who remain uncovered ... their stories transcend politics, reflecting tough kitchen-table decisions about health care faced by many families."

Interesting and thought-provoking.

■  Second up, FoIB JefF M (no relation) seems to have problems with the idea that health insurance rates have decreased buy some 3000%:

"States scramble to avert Obamacare sticker shock after Democrats balk at stabilization effort"

And by stabilization, they mean "throwing more money at it."

■  I can see no possible way for this to go wrong:

California Senate Bill would outlaw short-term health insurance 🤔#SB910 #California #STM #HealthInsurancehttps://t.co/I9coXHu8yX

— David Fluker (@FlukerDavid) April 3, 2018

■ BONUS ITEM: Co-blogger Bob V tips us to this interesting story on why folks choose - often at their own peril - whole life plans. What's special about this is that Burt is an industry giant, and knows where of he speaks:

"Why didn’t Burt sell us whole life?”

Spoiler Alert: He tried.

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So, an interesting confluence of seemingly disparate health care financing lawsuits. First, the Golden State is suing an outfit called Sutter Health for a number of issues, including "[g]ag clauses on hospital prices, 'All-or-nothing' contracts, [and] 'Punitively high' out-of-network charges."

I think it's safe to say that other provider networks and hospitals are watching this case very carefully, since it's likely that Sutter isn't a "lone wolf" in this. And of course, with all the mergers and hospital acquisitions the past few years, there are quite a few communities that have only one or two such organizations, and thus little (or no) competition to keep their prices in check.

Speaking of hospitals and pricing, our second story involves a concept called "reference-based pricing." Briefly, this is where an employer enters directly into a contract with a hospital (or other health care provider, one supposes, including DPC). This has some important advantages for the employer (else why would they bother?), but can carry additional risks, as well, namely balance billing. This is where the provider charge the patient/insured the balance between what's billed and the amount the insurance company pays. In a regular PPO-model insurance plan, this is verboten, but since this is a direct relationship  between the employer and the provider, it's perfectly legal (although apparently frowned upon).

And here's where that risk can become a real problem:

"The conventional wisdom is that this is rare ... And if balance billing does occur, it is easily resolved via a little back-and-forth negotiation between the hospital and the third-party administrator or employer. "

And that, your honor, is when the fight started.

[ed: one wonders, also, if that backroom "negotiating" isn't full of potential pitfalls and perils as well, including anti-trust and discrimination issues]

The thinking had been that no provider is going to risk the bad press that would come with suing a patient. But in this case, that thinking is wrong. Now it may have something to do with the size of the (balance) bill: over $80,000. But it also may be related to the phenomenon we noted above: that is, if you're the only game in town, then why would you care about bad PR?

Something to consider, no?

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I'd forgotten this:

sabotage - n. when Republicans make Obama’s 2010 health care plan look like his 2008 health care plan.

HT: RT @greg_fann

https://t.co/NSjCexNrgj

— Michael F. Cannon (@mfcannon) April 2, 2018

Nice.

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