It is so interesting for the topic of Americans foregoing health insurance to come up,
shortly after I watched a video on TikTok from an ER doctor who is doing the same thing. User
@apparentlimd advises in his video, dated January 26, 2022, that he does not currently have
health insurance because he believes that it is a scam designed to inflate health care costs,
resulting in larger payments made for services that would be much less expensive if the patient
opted for a cash payment system. Here is a link to his video if anyone is interested:
https://vm.tiktok.com/TTPdkrxv7T/ My sincerest apologies if the link tries to force downloading
TikTok.
a I personally think that this is a really interesting concept. I have, fortunately, had
health coverage for most of my adult life, either through Tricare when I was active duty and
now, as a military spouse, or through the VA when I separated from the Air Force. I have very
little hands-on experience with traditional health insurance featuring premiums, copays, and
deductibles. I did, however, utilize Planned Parenthood for birth control during a lapse in
coverage for approximately one year, which was a cash payment of $50 per NuvaRing, monthly.
This was a good option for me at the time, as I was relatively healthy and had no outstanding
health issues. To this day, if I couldn’t afford health insurance, I don’t think that it would be the
end of the world, as my health status remains much the same. However, much like other forms
of insurance, health insurance may not seem absolutely necessary until you are placed in a
situation where it would be vastly improved or less bleak if the insurance were in place.
a The flip side of the coin is that insurance can be incredibly expensive, even if never
used. I have several friends who have insurance but must use it sparingly because of the costs
associated with copays. Davis (2007) advises that most growth in the number of uninsured lies
in working adults unable to afford premiums for insurance plans offered by their employer. Dr.
Sherry Glied advised that people without health insurance run several risks; the risk of missing
routine care, the risk of treatable illnesses becoming serious problems, the risk of missing out
on better care when they are sick, and the risk of intense or extreme monetary losses (PBS,
n.d.). Davis (2007) advises that the uninsured are also more likely to receive care that is less
coordinated, have difficulty accessing medical records when needed, and experience other
indicators of lower quality care, like not being notified of abnormal lab results.
a However, as we move into the future, it seems as though there is a subscription or a
membership for everything, including healthcare. Rasberry (2020) writes about cash pay
doctors that operate with a monthly or yearly membership, providing services on an as-needed
basis while developing the patient-doctor relationship to establish continuity of care.
Furthermore, Rasberry argues that these doctors are just as adept at addressing one’s medical
issues and, in fact, are in a position to spend more time, if necessary, with their patients to
address all necessary issues (2020). This appears to offer a nice counterbalance between having
health insurance coverage and going uninsured, affordable yet thorough.
References
Davis, K. (2007). Uninsured in America: Problems and possible solutions. BMJ (Clinical research
ed.), 334(7589), 346-348. https://doi.org/10.1136/bmj.39091.493588.BE
Public Broadcasting Service. (n.d.). Healthcare crisis: The uninsured. PBS.
https://www.pbs.org/healthcarecrisis/uninsured.html
Rasberry, J. (2020, July 31). The rise of cash pay doctors: What they are and how they work.
Point Health-Smart Healthcare Platform. https://www.pointhealth.com/post/the-rise-of-
cash-pay-doctors-what-they-are-and-how-they-work
