This is a long article but really worth looking at. It breaks down the medical costs you pay and has an interesting proposal at the end.

How to negotiate directly with physicians and hospitals.

...I am talking about how to, in many instances, remove the middleman, in this case the health insurance company, and how to negotiate directly with healthcare providers, specifically physicians, hospitals, diagnostic facilities, and pharmacies. This is a discussion about how to negotiate to pay less for healthcare, and not a discussion about how to not pay for healthcare.

...My presentation, today, will mostly be limited to technique and tools, that is, how to negotiate. Why we should negotiate directly for healthcare is mostly outside of the scope of my presentation, but I imagine we will probably get more into that during the discussion to follow.

You are going to need five things, which I am going to give to you, today, free of charge!

1) Some absolutely critical industry vocabulary

2) A clear understanding of how healthcare is priced in the USA

3) Insight into to actual pricing

4) A proven negotiation strategy, including:

a. The point of contact

b. Foreknowledge of what prices medical providers will usually agree to

c. A sample offer and agreement

5) The confidence to successfully negotiate...

To begin to understand how healthcare is priced, we are going to look at 1) the doctor's bill given to a patient, 2) the claim forms the doctor and hospital send to the insurance carrier, and 3) ERAs that the insurance carrier then send back to the patient and the providers.

As we have already learned, all healthcare services have been assigned a code by the AMA, a five digit CPT code. So, if you trip and fall off your patio, you might get a doctor’s bill like the following table...