We are all de facto cash payers when one considers deductible and copays.
And, people are finally wising up that paying cash for many meds is cheaper than paying the copay for the insurance-negotiated price.
Consider that health insurance is merely an option contract, expiring monthly, which implies the rights to purchase unknown medical services at nondisclosed prices from non-obligated third party vendors emdors.
Options can be offered by a "cash patient GPO".
These options would include definition of underlying service to be purchased, strike price of that underlying service, and expiry date (before which that service may be purchased).
Medical professionals could sell these options directly to patients, and keep the premium price of the option themselves. Why should some third party financier monetize the future performance of doctors, without paying the docs anything for it?
GPO Patients could be allowed to know who and where are medical professionals who comprise "open interest" of short option contracts for any given medical service.
This would create the first truly borderless network outside of Medicare.
Medical professionals would love to get paid, immediately, a known price and save 6 figures a year on billing coders and denied claims.
(GPO would need to pay $1 more than any insurance accepted by a given doctor, the issue being "most favored nation" clauses.)
Patients would be big net winners in all scenarios involving typical, non-catastrophic healthcare.
Catastrophic care insurance premiums could be quite reasonable, and would plug that hole.
Patients could take over the task of filing claims for reimbursement with their own health insurance companies, spending their own time (rather than doctors' premium time) dealing with arbitrary claims denials.
Pharmaceuticals prices cannot be addressed until laws change.
In many cases, medical tourism is indicated.
A large enough group of affected Americans might seek judicial review of restrictions on purchase of life-saving pharmaceuticals from outside US borders given that many of the components of the pharmaceuticals are produced in other countries.
The whole cash-pay GPO system could run parallel to the current corrupt third party payer system until non-political class gains the understanding and confidence to reject this devil they think they know.