Personal medical experience: a recent 3 hour emergency room visit was billed at nearly $6000.00. Informing the hospital up front that I was paying out of pocket, the bill from the hospital came to $815.00. I have high deductible major medical (several hundred bucks a month). Being in NJ, no HSAs, but I have a tax-free Roth IRA that would cover the deductible. Hospitals, doctors, pharmacies, medical service providers are thrilled to sidestep the paperwork of insurance submission. Ask for the going rate between you and them, leaving out the insurance company. Voila! Lower costs for you, lower premiums for competitive insurance companies not burdened with all the less-than-Major Medical costs. Throw in tort reform prohibiting ridiculous liability costs for doctors, and the “healthcare crisis” is well on its way to recovery, gone the way of the equally mythical Global Warming scam.