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Age of Obamacare Drives New Kind of Health Coverage: Cash-Only

The era of what this space often calls “sort-of” health insurance has been with us for some time now. “Sort-of” health insurance, best exemplified in recent years by policies sold through exchanges under the banner of the Affordable Care Act, is characterized by expensive premiums, as well as enormous deductibles.


The combination of costly premiums with impossibly-high deductibles has left those maintaining such policies to essentially have health coverage merely in theory; while they technically have insurance, the functional utility of the coverage is minimal, at best.

Enter a new era in health coverage, one that has arrived precisely as a result of all the glorified major medical policies now being sold as “real” insurance: Cash-only care.

Cash-only medical coverage isn’t insurance at all. It is, instead, a straight cash-for-services model.

You’re probably wondering, “So, are legitimate doctors really doing this?”

You bet they are.

At its core, here’s why it works: The sums so many are currently paying for largely-valueless policies are so high that doctors are finding these individuals can actually get a better deal by simply paying cash for their medical services.

Think about it. Even a family of relatively modest earners can easily pay $20,000 just in monthly premiums…and then, when they have an actual claim, may be required to hit a threshold of $10,000 or more each year to realize anything approaching true insurance benefits.

As outlined over at, the Surgery Center of Oklahoma is one such cash-for-care, or “direct pay,” facility. The hospital’s website lists the “all-inclusive” price for each procedure, like the sum for setting and putting a cast on a broken leg: $1,925.00.

The Surgery Center of Oklahoma accepts no insurance, not even Medicare or Medicaid. “We say, ‘Here’s the price. Here’s what you’re getting. Here’s your bill,” says Keith Smith, who, along with fellow anesthesiologist Steven Lantier, founded the Surgery Center back in 1997. “It’s as simple as that.”

As a matter of fact, part of the arrangement at the Surgery Center is that if complications ensue following a procedure, the facility foots the bill for that. In other words, once the patient pays the list price for their procedure, they’re done paying.

The future of direct-pay care? As long as major medical care, masked as real health insurance, continues to be forced on Americans at ridiculous costs, then it looks to be pretty darn good.

By Robert G. Yetman, Jr. Editor At Large