My friends, we have created a monster. It’s bigger than we realize, uglier than we care to admit, and we have convinced ourselves that we absolutely need it to survive. So we nurture it, protect it, and let it continue to grow. Now not only have we created it, we have let it take over one of the most important aspects of our very lives – our health.
Yes my friends, I am talking about health insurance! (I can hear the shocked gasps and protestations beginning already.) Hear me out.
For most of recorded history, health insurance wasn’t a thing. It didn’t exist and had no equivalent. People paid for medical services as they needed them out of their own pockets. Doctors (or whatever their equivalent titles were) were another type of tradesman, selling or bartering their services in the local community. Fast forward to the late 1700s and 1800s though, and our very communities start to change thanks to the industrial revolution.
As factories grew, life became less rural and self sufficient and more urbanized and wage dependent. If something happened and you couldn’t work, both you and your family had very few options. Those new factories were very dangerous places to work indeed. The frequency and severity of injuries were piling up. Something had to be done! So workers started banding together to form mutual aid societies. Everyone would contribute, pooling their resources to cover medical expenses or lost wages due to illness and injury. Over time social pressure and government involvement spurred by World War II created the health insurance industry.
Early insurance coverage was very limited. Mostly, it only paid for hospital stays. Insurers had little to no involvement in medical decisions, unlike today. Doctors and patients largely determined care, while insurers provided reimbursement based on submitted bills.
My, how things have changed!
Today health insurance coverage has expanded not only to hospital stays, but also to all things routine. However, with that expansion has come the need to control costs. After all, businesses are in business to stay in business otherwise they cease to be a business. (Say that 3 times fast. 😄) It is this expansion and the subsequent cost savings measures that have lead to the creation of the monster we have today.
Because of the way insurance now works, doctors are pretty hampered on how they can treat their patients. Medical professionals now have to consider, if I do X will I be compensated for it? I’m sure you’ve got your own stories, but I’ll share a few here. Everyone’s body is different, so I know there are times when doctors struggle to label a patient with a diagnosis so that the tests they need to run, or the treatment they would like to prescribe will be covered by the insurance company. Someone once told me that they’ve heard of insurance companies declining to pay for a surgery as the patient was getting ready to go into the operating room. Or what about a surgeon having to end a surgery before they were done because the insurance disallowed the extra 20 minutes needed to complete things due to some unforeseen hiccup? Now that patient will need a second surgery and all the risks that go with it because there was some kind of unforeseen complication that caused things to go just a little longer than the insurance thought it should take. Or how about this one, a patient is experiencing chronic jaw pain and would like to be placed on a new medication for better relief. The doctor agrees, but the insurance company won’t allow it. The patient then has to either live with the pain, or jump through all the hoops in order to have a reconstructive jaw surgery which will then necessitate time off of work, recovery time, etc. etc.
How in the world did we get here? Insurance used to help pay the bills but now they’re dictating care! Well, like any good monster it grew because we fed it. We demanded more and more coverage. Health insurance should come with the job! Health insurance should be available to everyone! Health care is a basic human need! But is it really?
I had some questions about that. I know that health insurance both increases the costs to doctors by creating more overhead and lowers their compensation because of PPOs, DRGs, insert your alphabet soup heres. So, I asked Grok to help me do a little research.
Here’s the scenario: How much would it cost for a simple procedure, say lancing a boil, for an uninsured patient versus an insured patient? Here’s what came up:
Key Cost Breakdown
| Aspect | Uninsured (Self-Pay) Cost | Insurance Payment (e.g., Medicare Reimbursement) | Notes/Difference |
| Procedure Fee (CPT 10060) | $378–$800 (national average ~$500–$600) | $70–$110 (national average ~$90–$100; ~$122 in some older data, adjusted down for 2025 PFS cuts) | Self-pay is 5–8x higher. Insurers negotiate deep discounts to control costs. Location matters: e.g., $439–$734 in CA, $379–$634 in TX. |
| Office Visit (E/M Code, e.g., 99213) | $100–$200 (bundled or separate) | $70–$90 | Often bundled into procedure; adds ~20% to total for uninsured. |
| Total Out-of-Pocket for Patient | $500–$1,000 (full amount due upfront) | $20–$100 (copay/deductible; e.g., 20% coinsurance on $100 reimbursement = $20) | Uninsured pay full; insured pay only share after meeting deductible. |
| Provider Revenue Received | $378–$800 | $90–$110 | Highlights the “chargemaster” vs. negotiated rate gap; providers often lose money on uninsured if not discounted. |
Grok went on to explain: Providers set list prices (chargemaster rates) high to offset low insurer reimbursements and administrative costs (e.g., claims processing). Uninsured patients are billed these full rates, though many offices offer 20-40% cash discounts or payment plans.
It provided a real world example: In a primary care office in Texas, self-pay might total $550 (procedure + visit). Medicare would reimburse ~$95, with the patient paying ~$19 copay (after deductible). Total system cost to insurer/patient: ~$114 vs. $550 uninsured.
It then concluded that uninsured patients subsidize insured ones indirectly.
That’s INSANE!!!!!! Still reeling from this information I asked Grok for a hypothetical scenario. If healthcare didn’t exist, how much would that same procedure cost?
Its conclusion after running the numbers: In a no-insurance world, lancing a boil would likely cost $55–$95 (average ~$75) in a primary care office, compared to $378–$800 (average $500–$600) for current self-pay patients and $90–$110 in provider reimbursement for insured patients (with patient copays of ~$20-$100). The dramatic reduction reflects eliminated administrative overhead, competitive pricing, and alignment with actual service costs. For context, cash-based practices today charge ~$100-$200 for similar procedures, supporting this estimate.
I don’t know about you, but that gets my blood boiling. Insurance was originally created to help cover large costs that were debilitating to workers. The monster that has grown has now raised prices to the point that trying to get healthcare without it has debilitating costs. Healthcare providers are forced to charge exorbitant amounts to those who aren’t part of “the system” and then it dictates the KIND of care you can get. That just isn’t right. The only people that should be involved in your health decisions are yourself and your health team. After all, no one knows your body like you do and you have the freedom to choose a health team that will work with you for the results you want.
Here at Chrysalis we stand for health freedom. We choose not to work with insurance companies. This choice enables us to bring our costs down, thereby making our services more affordable for everyone.
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