How to Haggle with Your Doctor

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Find out how directly from the source—a doctor.

In a Q&A in the NY Times, Dr. Jeffrey Kullgren, an internist at the University of Pennsylvania who is researching consumer issues as they related to health care, offers a range of ways patients with or without health insurance can cut costs. Nearly all of the tips start with this simple step: Ask your doctor if there’s any way you can pay less. That goes for any of his services, as well as prescription drugs, tests, and treatments.

If you never say that cost is a concern, your doctor probably won’t even consider a less expensive course of action. Why? Kullgren explains:

I was trained to give the very best care for my patients, regardless of cost.

So are all doctors. Therefore, it’s up to the patient to bring up the topic of cost to have a prayer of keeping it under control.

One of the most frustrating aspects of our health care system is the insult-to-injury situation in which patients without insurance are routinely charged more than those who have coverage. What’s Kullgren’s insight here?

What’s happening is that people without insurance are paying full price, while insurance companies, with their high volume of patients, can negotiate steep discounts. For patients paying for care out of their own pockets, it’s important to let everyone you encounter know that. The next step: ask for the discounted rate.

The reality is, you may not have as much leverage as the big insurers. But it almost always pays to ask.

Again, it’s up to the patient to bring up the subject, no matter how awkward that may make you (or the doctor) feel. Nobody’s going to cut you a break unless you ask for it.