I once said here that to cut the cost of medical care in half we need only make health and medical insurance illegal. I wasn’t suggesting that we actually do that, but only that the result would be much cheaper medical care, and that this suggests something about the mixed blessings of the whole concept and reality of insurance. Clearly people demand more of that for which they do not directly pay, and that demand can push up prices.

But what I didn’t address at the time was the direct additional cost due to the processing of insurance claims. This is an issue with both private insurance and Medicare and Medicaid. One solution is gaining adherents in the medical fields: cash only medical care.

The newsletter Independent Living reports that some doctors are going to a cash-only business model, and refusing any insurance including Medicare and Medicaid. The result is cheaper medical care. For example, Dr. Kevin Peterson, a general surgeon in Las Vegas (NoInsuranceSurgery.com) charges $5,000 for a hernia repair, which is about a third of the usual rate. He still has a gross profit on that operation of $2,000 thanks to a streamlined business that doesn’t have to deal with government or insurance company bureaucracies – which is apparently more than most doctors make on a medicare-paid surgery of the same type.

I have to admit that it seems odd for the cost to be two-thirds less, but then that probably varies according to the procedure and the specific doctors and offices that have this policy. Most likely the doctors who cut out the trouble of billing problems are also good at cutting other expenses.

It’s an intriguing idea, but I suspect that the more we move toward a government-paid health care system, the less this will be allowed. Expect to see laws requiring all doctors to take insurance or at least accept Medicare and Medicaid patients. At some point it will be the only way to keep the system together, since too many doctors refusing to deal with anything but cash would put a great burden on those that remain in the system.

Of course such a law will be done in the name of the people – of whom I am not apparently one, since it will mean that the uninsured like myself will have to pay that three-times-higher rate again. (And when the day comes when we are forced to buy insurance we will pay for it in that way.)