During his radio show today, Rush Limbaugh made a very blunt case we don't hear stated so clearly by Republicans -- that not going through health insurance is better than using it, because it creates a direct link between the patient and the price, and creates the incentive to shop around:
"You oughtta try this, folks, just a standard doctor visit, offer to pay for it yourself," said Limbaugh. "I guarantee it'll cost you less than if you use your insurance."
Josh Marshall commented on this idea yesterday: "To be clear, such an approach probably would cut costs because most people just couldn't afford to get a lot of care, which is a great way of cutting costs. But remember, the problem according to most Republicans in Congress isn't that there's not enough insurance or that it's not good enough. It's that there's too much. The problem is that you have insurance. And good policy will take it away from you."

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CT Voter
September 9, 2009 5:55 PM
Someone should ask Mr. Money Bags ("I have 20 million listeners") Rush if he'll make up the difference, if he's wrong.
BTW, a complete physical with appropriate blood work from my doctor costs me $15.00. I have insurance, obviously. I imagine that Rush would dismiss a physical as "routine", though.
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Docb
September 10, 2009 11:55 AM in reply to CT Voter
Limpbow can guarantee nothing....except salacious lies and distortions..But now we and the media will be compelled to call him out more loudly and voraciously!
Ha Ha loudmouth liars called on the carpet..Nothing works better for fat old bullies! Call them on their stuff!!1
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CranialRectalLoopback
September 9, 2009 6:04 PM
He's right. If we have to pay out of pocket, we won't be able to afford to get sick. We will stop getting sick. Those who can't stop getting sick will die. Only the healthy and careful will remain. Demand for health care will plummet. Without demand, costs will drop like a rock. Simple supply/demand economics.
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Mt. Skullcrusher
September 9, 2009 6:04 PM
If it's one thing I trust Rush Limbaugh to do, it's doctor shop.
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de TOQUEville
September 9, 2009 6:16 PM in reply to Mt. Skullcrusher
Mega-dittos!!
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GayIthacan
September 9, 2009 6:26 PM in reply to Mt. Skullcrusher
ROTFLMAO!!!!!
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rynato
September 9, 2009 6:36 PM in reply to Mt. Skullcrusher
Yo, comment of the muthafuckin' day y'all.
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clif
September 9, 2009 7:07 PM in reply to Mt. Skullcrusher
Well he does receive a multi-doctor and bulk buy discount doesn't he?
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clandesdun
September 9, 2009 7:35 PM in reply to Mt. Skullcrusher
Depends, you wanna get well or you wanna get fucked up. If it's the later you should take whomever he highly recomends. If it's the former you'd be better off calling 1-800-I'm-too-big-a-wanker-to-figure-out-what-doctor-to-go-to
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jeffgee
September 9, 2009 6:09 PM
Sure, for ordinary exams it would be cheaper just to pay the bill out of pocket, but if you go to a hospital without insurance or have a catastrophic illness or injury, they charge you more and there's not much you can do about it. But it's all about Rush. If HE can afford any medical procedure he needs, all is right with the world.
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twirling fartknocker
September 9, 2009 6:12 PM
great minds and all
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Buckeye Terrorist Fist Jab Nation
September 9, 2009 6:17 PM
Yeah right, Windbag.
Type I diabetics are better off paying retail for their daily insulin shots.
What an unthinking dumbass.
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CVille Dem
September 9, 2009 6:20 PM
Well, Rush is certainly the picture of health!
Morbidly Obese
Drug Abuser
Obviously Miserable
Impotent
We should do whatever he says, for sure.
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Minne sconsin
September 9, 2009 8:10 PM in reply to CVille Dem
You forgot the pilondial cyst that kept him from serving in Vietnam.
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Minne sconsin
September 9, 2009 8:13 PM in reply to Minne sconsin
Danged linky-thingys:
Pilondial cyst
A pilonidal cyst, also referred as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris.
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Tim
September 10, 2009 5:06 AM in reply to CVille Dem
Makes quite a few junkets to Dominican Republic and back with unprescribed viagra in tow. Since the Dominican Republic is know to harbor quite a few high class resorts that function as brothels, I'm assuming he's perhaps a health risk for sexually transmitted diseases.
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midnight rambler
September 9, 2009 6:20 PM
I assume he gets away with this kind of shit in part because his listeners with health insurance don't actually know what a doctor visit costs, and those without don't go?
It's interesting to note, BTW, that here a GP visit costs $150 cash, whereas in Ireland (which has universal coverage for public hospital care, chronic conditions, and poor people, but all else is out of pocket) it costs $50. Oh and also you can pretty much walk into a doctor's office there and get an appointment that day, whereas here I usually have to wait a month to get one.
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Matt Jones
September 9, 2009 8:08 PM in reply to midnight rambler
He gets away with it because most of his listeners can't count to 20 without taking their shoes off. They wouldn't be able to figure out an insurance bill in a million years.
Also, as others have noted, Rush has previously demonstrated his affection for "doctor shopping"...
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RobertSeattle
September 9, 2009 6:22 PM
Riiiiight Rush. You are in the Ambulance with a heart attack and YOU are going to go the the cheapest heart surgeon...
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Moose49
September 9, 2009 6:24 PM
Limbaugh's not only a windbag -- he's an utter moron. If I go to my doctor without insurance, I'll be charged $120 for a typical visit. However, my insurer, BlueCross, knocks the price down to around $80. If I haven't hit my deductible, that's what I pay and if I have, I pay $20.
It's even worse if you go to a hospital. And unbelievable if you have to go get a blood test. I've had labs charge over $100 for a simple blood test, which BlueCross knocks down to $7.
When you don't have insurance, you have no purchasing power and you're forced to pay the maximum rates no matter what.
And of course, God forbid you have a serious accident, have a heart attack or get cancer, because you'll be looking at bills in the six- and seven-figure range. Not a problem if you're a multimillionaire moronic windbag, but for the rest of us...
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mans_best_friend
September 9, 2009 6:27 PM
Obama should headline his speech tonight with this. ANYONE can see what complete bullshit it is. It's a perfect lead-in to a discussion of all the other nonsense that's been spouted.
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traitorjoe
September 9, 2009 6:31 PM
Limbaugh buys his OxyContin pills out of a paper bag in a supermarket parking lot, so he has no need for doctors or insurance.
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rynato
September 9, 2009 8:54 PM in reply to traitorjoe
Most people don't get really, really sick but many people need routine care like for diabetes or other chronic conditions. Others need to visit regularly to monitor certain conditions like high cholesterol.
If you can't afford this kind of routine care, you don't get it and you end up worse off in the long run, and then you end up in the emergency room and we all pay for it, not to mention the damage it does to a family to lose a breadwinner to health issues which could have been prevented.
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mans_best_friend
September 9, 2009 7:00 PM
Limbaugh has unwittingly put his finger on the crux of the problem selling the public on health care reform. For people who don't get sick (that's most people), not having insurance WOULD be cheaper. The amount you pay for insurance far exceeds what they pay out in benefits. If you fall into this category you're probably pretty satisfied with your health coverage, even if you have very poor coverage.
Here's a question for you, Rush: Do you have fire insurance on your house? For most people, not buying fire insurance would be a big savings. Hardly anyone has his house burn down. The problem here is obvious. The 1 in 10,000 who has a fire loses everything. That's the essence of insurance - it's pooled risk. You have to have lots of people who are net losers in order to pay for the few who run up big costs. We buy insurance because you can't know if you're going to be the unlucky schmuck who gets really sick and needs it. And in the case of health care, you know that it's not a matter of if but when.
Since the large majority of people fall into the category of rarely getting sick, so they don't encounter problems with their health insurance and they're satisfied. It's only the unlucky few who get sick and really need insurance that find out how big the problems really are.
Most people don't get sick much so they never see the problems. For Obama to sell this he has to make people see the problems. That's not an easy task.
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Technowitch
September 9, 2009 7:07 PM
This begs the question: Does Limbaugh himself have health insurance? If so, to what degree is it platinum-plated?
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pirate jenny
September 9, 2009 7:13 PM
i don't have insurance and recently i was very sick and worried it might be pneumonia so i went to a gp.... for the first time in 8 years. total cost out of pocket including meds was over $600. i just hope i can stay well until i turn 65, or at least marry a canadian.
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KZ
September 9, 2009 8:21 PM in reply to pirate jenny
Ha - I called my gp because I had what might have been heart attach symptoms. She told me to go to the emergency room. They did an EKG, a chest x-ray and a cat scan. My bill, and I have private insurance, came to $6,000. Maybe I'll send the bill to Rush. What an asswipe.
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KZ
September 9, 2009 8:22 PM in reply to KZ
make that heart ATTACK symptoms - my heart's already attached.
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USgreentech
September 9, 2009 7:15 PM
Rush Limbaugh is still on the air? The sooner the better the guy gets taken off the air.
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Whenwillthisnightmareend
September 9, 2009 7:18 PM
If this quack was a doctor, this advice would be considered Malpractice. I hope these guys keep it up, they are getting more whacko every day. Only problem is, the average American isn't getting any smarter.
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shooter242
September 9, 2009 7:42 PM
Two items you folks might be missing for context. He was responding to a woman who needed an Xray for her toe and the first place wanted $269.00. She eventually found a place that charged $20.00.
Second, the Baucus bill will ensure that everyone HAS to buy insurance or be charged a $3800.00 fine levied and enforced by the IRS. But hey, that's OK, right?
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midnight rambler
September 9, 2009 9:32 PM in reply to shooter242
If there is a place that charges $20 for an X-ray, they're almost guaranteed to be either subsidized, or unlicensed and fraudulent. That might be what it costs to take the picture, but it doesn't cover having someone look at it to see what's wrong.
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clandesdun
September 9, 2009 11:55 PM in reply to midnight rambler
Or the employee did it on the sly and pocketed the 20 on hir/her way to shop Rush's doctors.
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psyclone
September 9, 2009 11:40 PM in reply to shooter242
Wow, someone who actually believes what Rush Limbaugh says. How quaint.
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Delores
September 9, 2009 8:01 PM
Limbaugh is a multi millionaire. He can/could afford to pay for healthcare out of pocket...even for multiple chronic and/or terminal conditions, such as diabetes, cancer, brain surgery etc...and for weekly mental health care.
If his loyal listeners follow his "pearl of wisdom", it would be the surest way to make them sour on him. Especially if they have to cover family members and not just themselves, and then one of their loved ones gets diagnosed w/ cancer. They'd then have a preexisting condition and would not be able to be covered by health insurance.
He is making a point that dovetails w/ health insurance reformers/pro-public option: health insurance is too expensive for a lot of people and without it, the prices charges for doctor visits, tests, and treatment are prohibitive.
Many people, who have been lucky enough to be covered by employer backed insurance, don't realize how expensive healthcare has become...they are sheltered from real prices (different from real costs). Unless they are denied coverage for something, they can get whatever they need taken care of for $20 or $25 and don't worry themselves about the "what ifs".
I hope Rush's listeners heed his advice....then we'll see what disaster follows. Unfortunate for them, but maybe it will finally make "his" people question what he says a bit more
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Rational Realist
September 9, 2009 8:06 PM
I have tried this twice for "standard office visits" and it did not work. The doctor's office did not have mechanism for direct pay and could not tell me the price. I even called ahead to get the price and was given a vague answer. It is apparently easier for doctors to bill the insurance company.
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midnight rambler
September 9, 2009 9:38 PM in reply to Rational Realist
I've also noticed that most of the statements from my insurance company say something like this:
original charge: $150
insurance negotiated price: $123.57
amount paid because we didn't feel like paying any more: $106.23
therefore you still owe the doctor: $17.34. Expect a bill.
But I never get billed for that extra charge, maybe because it's too much hassle for the doctor. Which, I suppose, just goes to show how much they're ripping off the people who don't have insurance when they're doing just fine on what they do get paid.
Also, I've noticed that some places charge more for paying in cash, while others charge less. And our local walk-in clinic, which one would think would cater to the large proportion of people around here who don't have insurance, won't take you if you're uninsured. I've never understood any of those.
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ivy22
September 9, 2009 10:43 PM
Out of pocket??? If he reached in those pockets he would come out with controlled substances, pain killers, muscle relaxants, and cigar butts.
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clandesdun
September 10, 2009 12:09 AM
Ever try paying cash for a doctor visit? I did at one of those emergency medical places. Got two stitches in my knuckle. No x-rays, a little shot of topical numbing stuff ( yes, that’s the medical term) After several phone calls they finally admitted they didn't know what to charge me and refused to accept my money. Told me I'd get a bill in the mail. 6 weeks later sure enough a bill arrived. It was for $472.00 for maybe 15 minutes and two stitches. I called and asked them if this was the price for a cash customer and the woman on the phone said no, it was the same price they charged everyone. I told her that as a cash customer they had a totally different overhead as they did not have all the time involved in the insurance paperwork etc. We went round and round. She hung up on me, I hung up on her. She referred me to the home office and something like 96,000 conversations and 1 1/2 years later they reduced the charge to $175.00 and I paid it and vowed never again (pay cash that is, not visit a doctor). Sheesh, sometimes you gotta go a far assed way to prove a point.
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Mumon
September 10, 2009 7:16 AM
It costs $200.00 to see the doctor w/o insurance.
It's $30 to see him with insurance.
What planet is he on?
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Bob Miller
September 10, 2009 8:46 AM
One of the many scandals of the American health care system is that if you do NOT have insurance, the service you receive will cost MORE to you than to you and the insurance company combined if you DO.
Take a look at your insurance statement when you've had a significant test or procedure. There's an amount charged, and an amount approved BY THE INSURANCE COMPANY. The medical provider will not come after you for the difference, they will just accept the approved amount, which is often significantly less than the billed amount. That's because the insurance company has clout. You don't.
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kmellis
September 10, 2009 9:24 AM
As others have said, this is false. Is Limbaugh just making things up? It's very often the case that providers will charge uninsured people quite a bit more for a given procedure than they charge insurance companies.
However, there is truth to the claim that if you are self-paying, you can save a bunch of money by going to the trouble of comparing fees. This is because they vary wildly.
It's worth pointing out that anyone who champions a market oriented approach to health care—as Limbaugh certainly does—that this huge price variability (for the same service, for the same patient, with the same patient ability to pay) proves that the health care market in the US is very malfunctioning and inefficient.
Also, one notorious example of how broken this market is that should be more widely known than it is, is how widely varying different pharmacies charge for generic medications—for both the uninsured and the insured, but it's more extreme for the uninsured. Some pharmacies have hugely inflated prices for some generic medications for the uninsured. The most extreme example I'm aware of from personal experience is an antidepressant that is around $300 for a month's supply at a large, well-known chain pharmacy and only $25 at a
"wholesale" big-box store that has a policy of a set minimal mark-up on their generics. More typically, the higher prices I've personally seen have been about three to five times the lesser.
As someone mentions that Limbaugh discussed with his caller, this is true for things like X-rays, too. If you shop around, you can find a huge difference between highest and lowest, most especially if you're self-paying.
Unlike Limbaugh, I realize that this isn't a good thing. It's difficult to comparison shop for health care in the best of circumstances. But the fact that prices and fees vary so enormously indicates that the market itself is very distorted and inefficient.
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slinkypomo
September 10, 2009 10:23 AM
That actually seems pretty reasonable to me dude!
RT
www.anon-tools.vze.com
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Leftflank
September 10, 2009 12:33 PM
Rush Limbaugh is a "Big Fat Death Panel".
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scottchop
October 12, 2009 6:55 PM
I have no insurance. I had an MRI recently. I was told the medical open rate, that is the rate they would bill my insurance was $1,800. But since I was self pay, my bill would be just $500.
That's $1,300 cheaper for one test.
Two weeks later, I had a CT Scan on my sinuses....which you can see here...
http://proboscisproject.ning.com/
The insurance bill rate would have been $1,500....my self pay rate was just $300!!! That is $1,200 cheaper for paying out of my pocket.
I am having a VNG audiologist test tomorrow....insurance rate $1,000....self pay rate $400 !
I am not a Rush fan, but he is absolutely right on this one....
Seems to me that insurance companies and politicians are screwing the consumer over here...truly competing insurance companies would not allow themselves to be billed these much higher rates.
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