You can do this. You ask what the "cash pay" price is. You may be surprised to find that it's 20% of the rate quoted on your insurance. There's a reason for this. Because the insurance companies have become giant, multinational durian street hawkers, healthcare providers have become tourists on a jaunt. Or, more correctly, the other way 'round. "C-section. $28k." "Preposterous. There's no way this woman needs thirty thousand dollars worth of medical care. We'll give you a grand." "We literally cut open her abdomen and withdrew a screaming baby. 25 grand." "A perfectly healthy baby that probably would have been fine otherwise. 2 grand." "If the baby was going to be perfectly healthy we wouldn't have sectioned the mom! 20 grand!" "It's not our job to reward your medical cautiousness. 3 grand." "Actually, it is. You're an insurance company. 15 grand." "4 and that's my final offer, you charlatan." "4500 and I spit on your mother." "4750 and we'll waive the 5 grand you'll put on her bill so she thinks we're both magnanimous." "Sold to the man in the white coat." _________________________________________ No lie. My wife uses a service that takes 20% of whatever they can get back just for fighting with insurance companies. And no lie - my wife's bill inflates by about 500% when they get ahold of it, just looking for the codes that this particular insurance company or that one is sensitive to. And again, no lie - by engaging in this clusterfuck dork dance, my wife's families end up with insurance basically covering her cash price. As far as your edit, the biggest thing the ACA did was create a marketplace for health insurance, same as car insurance or homeowner's insurance. Is it going to be great? no. Is it going to continue being rapacious? Probably not for long. Especially as people in the middle figure out what us freelancers figured out long ago: buy the catastrophic, don't use it, and pay cash.Too bad the durian analogy doesn't continue though. If it did, I'd just wait until dark and steal the durian from the trees. Y'know, if I could stand the stuff.
And to think that the species that laid claim to fire spent all the time thereafter creating uncountable things worth burning. Some friends of mine had two of their three kids outside of the US and saved a fortune by doing so, but I didn't realize at all how insurance figured into it; it just wasn't part of my world. It didn't occur to me that I was able to ask to pay in cash. This is worth exploring, for sure. Thanks dude. It's good to get some perspective on this. After avoiding paperwork for so long, I begin to see how I'm expected to have a much better grasp on it than I do. Something I need to rectify.
Definitely second the recommendation about the cash price. Don't ask up front, however, because they'll tell you the price is the price and it isn't negotiable. This is for legal reasons. If after you get the bill, however, you call them and say, "I can't pay this much, but I'll give you 20% to settle," you might just find a lot of places will take the money gladly. Any non-profit hospital worth its salt doesn't want you to suffer, and they aren't in the business of burdening people. And as a pragmatic consideration, they know they aren't getting 20% (or whatever, start low and negotiate) form a collection agency whom they could sell the debt to. The bureaucracy that is our health care system would make the Soviets blush. You each have to pretend the sky is yellow and the sun is blue, and use that as your starting point.
Just remember - single-payer is the devil and will lead immediately to moral turpitude and communism. PROTIP: the key to success as a grownup is to realize that "things that are simple" and "things that are obvious" are designed to trap you, fleece you, skin you, eat you, digest you and spit you out. A preposterous amount of effort is spent on confusing paperwork, bait'n'switch tactics, institutional flimflammery and general malfeasance. It's not legal to make success impossible but it's legal and lucrative to make success a gauntlet of tedium and triplicate forms.