Facing surgery without insurance

I’ve struggled with writing about this, because it is intensely personal. Self pity isn’t my aim; I wish only to inform.

When the Internet company I was running (and in which I’d invested my life’s savings) finally went belly-up in 2001, and I lost my shirt, I found myself in the unenviable position of living in this country without health insurance. This was difficult for a prideful man, especially one who is getting up there in age and needs health care.

It’s a good news/bad news kind of a thing, and I want to share a few things that you might not be aware of. First, the bad news. I have a lump in my left breast that needs to be removed, and I’m having surgery on Thursday. I’ll find out Friday if it’s cancer, although I must say that’s pretty darned rare. It is, however, breast cancer awareness month, and you’d better believe I’m aware. Facing something like this without insurance isn’t fun.

But there is good news.

Did you know that nearly every heath care provider in the country offers deep discounts, if you pay cash? The minimum discount I’ve encountered these past few years is 30%. A doctor’s visit that costs you $20 and your insurance company $80, costs me $70. You want to cut health care costs in the U.S. by 30%? Eliminate 3rd-party payers.

I’ve also discovered that most doctors and health care providers really do care about people. When you get into that insurance mill thing, the human aspects sometimes to get pushed to the side, because it’s all about money. When you walk into a place and announce that you’re “self-pay,” it’s amazing what can happen.

Maybe I’ve just been lucky, but I have the greatest doctor on the planet. She knows that I’m building a business and don’t have a lot of money, so she helps me by sharing samples that the drug companies give her. The surgeon who’ll be doing the work on Thursday didn’t charge me for the consultation ($100) and is going to ridiculously discount the operation. He also promised to speak with the anesthesiologist and pathologist on their charges. The outpatient surgery center is discounting the use of their facility by 75%. That’s SEVENTY-FIVE PERCENT! In all, I’ll end up paying about one-third (or less) of what this would’ve cost via the 3rd-party insurance method. And best of all, a dear friend is lending me the money to pay for this. I’ll pay him back; you can bet on that, but his help comforts my soul.

All of this gives me pause. As a student of human nature and a professional observer of life, it’s easy to get jaded in this day and age. As Pogo said, “I have seen the enemy, and he is us.” But there is something at core in people that — if given a chance — is begging to come out and make itself known.

We are not a culture of automatons, driven only by logic and reason. We have an emotional side that’s every bit as important, and this is why secular Modernism is failing. We are spiritual beings on a human journey. That, and our unrelenting curiosity, is what gives me hope for the future.


  1. Thanks for your courage, Terry.

    You have lots of people standing with you…

  2. Good luck Terry!

    Dr Dave is right.

  3. Nothing but good thoughts, Terry.

  4. Can’t wait to read the “It’s Benign!” post as soon as you’re up to getting back to the computer post-surgery. 🙂 Thoughts, prayers, vibes, energy, and the like all coming your way.

  5. mel taylor says

    you are in our prayers terry.

  6. Peter Janick says

    Medical billing is travesty. The “list cost” of procedures is almost always at least twice what gets reimbursed by insurances. No insurance company ever pays full price — only the unfortunate without insurance. Practitioners and hospitals will take what they can get and will discount but only if pushed. The public shouldn’t stand for this and no one should have to pay much more than the providers will accept from the insurers.

  7. Terry, I hope all goes well.

    Thanks for the great insights on self-pay health care too. I think few people realize there is room for negotiation.

  8. I agree with Peter; we shouldn’t have to stand for this kind of national travesty. But that aside, my best wishes for a speedy recovery, Terry.

  9. Frank Gilkeson says

    Here’s a tip. I am now 63 after “losing” my Silicon Valley job in 1999 after working in hi-tech for 34 years. I quit working and collect early SS. Last year I left California and moved to the North Georgia mountains. My wife and I have $10,000 annual deductable health insurance from BCBS of Georgia. It costs $125 each per month. For this we get to pay the same amount for medical services that BCBS pays which is a “big” discount, usually 50–75% off. The $10,000 annual deductable protects us from a medical catastrophe. Four doctor visits a year cost $40 each for annual exams/preventive care

    I do not believe that you can buy such a policy in California. Too bad.

  10. Our prayers are with you.

    I met you at Gnomdex this past summer, and was blown away by your presentation. Please let us know how things work out.

    I expect to see you at the next Gnomedex to give us an update on how you are bringing the blogosphere into the local new world!

    Get well soon.


  11. Thinking of you, and wishing you a speedy recovery.

  12. Terry,

    I will remember you in my prayers today — we all wish you the best, and hope that all goes well.

  13. I delayed getting a biopsy done on some visible growths because I didn’ have insurance for some time. And thinking about consequences alone depressed me. When I was able to afford it, I got it checked very recently. It turns out they were benign. I’m relieved. I hope you can have the same feeling. Good luck.

  14. (squish- mmmmm, mmmmm mmmmmm ‑squish) That was a giant hug. Sometimes we just need a giant hug in times like these. Wish I was closer to give it to you in person. 🙂

  15. susan mernit says

    all good thoughts and prayers for you, Terry!

  16. This long time Canadian reader (who thanks God for our poorly run, but accessible-to-all Healthcare System) is praying for you.

  17. Come to Germany, get a $600-a-month-job, and our health care system will pay every treatment you need.
    Hmm, when I think it over… speaking at least a little German will help…
    Two things almost all Germans adree upon:
    — We still have the one of the best health care systems in the world
    — It was not necessary to invade Iraq
    … maybe these two points are in some unfathomable ways interconnected

  18. rugdesigner says

    I’m wishing for you the best possible outcome and a speedy recovery!

  19. Best wishes — and you’re right. medical professionals are often unduly vilified in the debate over healthcare in this country. Most of them do care about their jobs and their patients.

  20. Best of luck to you as you’re dealing with this. It can’t be easy. Let me know if you ever need anything.

  21. ‘wishing you the best and a speedy return to the great things you do!

  22. Here is a thought for the successful among us (entrepreneurs) to consider: what about an Entrepreneurs’ Fund of America… similar to the Actors’ Fund of America. Here is something from their web site: “The more successful members of the entertainment community decided to assist those who were less fortunate in the industry by collecting money from their peers. Thus, The Actors’ Fund was founded with a tradition of ‘taking care of our own.’ ” Don’t we have a large number of extremely successful and fabulously rich entrepreneurs… and of course an even larger number of those that diligently tried and didn’t make it… all part of the entrepreneurial system of “betting”… of “winning” and “losing”… which, we all agree, is so vital for the economy.

    Terry… best wishes!

  23. Just adding to my previous post… Personally, I would prefer such an organization to be engaged in the establishment of affordable insurance plans… rather than in personal giving or occasional fundraising.

  24. Wow, what a scary ordeal. We will be keeping you in our thoughts, and will keep a close eye on this space, to hear about what happens next.

    Best wishes for a speedy, full recovery –

  25. I wish you all the best. Get well soon.

    Just a note on third party medical payments.

    Third party payers do not pay the list price. They negotiate deep, deep discounts. So what you are paying is probably about what a third party payer would pay.

    This comes from a story in the Wall Street Journal a few months ago. They compared the list price charged to self pay patients with what third party payers paid for the same procedure. They found that third party payers routinely demanded and got deep discounts to list. In fact, these discounts were so deep and so rountine that list price was meaningless for third party payment purposes.

    They also reported, in another article, that savvy self-pay patients like you have caught on to this. These patients routinely ask for and get the kind of discounts given to third party payers.

    I guess the moral of the story is that medical care prices are now like car prices. No one pays list.

  26. good luck with the surgery. hopefully, we’ll all tackle the ridiculous state of health care insurance in this country soon enough.

  27. Terry,

    All the best Brother!

  28. Terry,

    Doug and I will be keeping you in our thoughts as you head off to the hospital, praying that the odds are in your favor– and everything will come out fine.

    I completely agree with you about the insurance companies and the third party billing “experience.” It’s enough to make you want to scream ENOUGH when you encounter the BS they put you through just to get the benefits you paid to get in the first place.

    Dr. Doug, Pharm.D. and my other half told me to remind you, that should you need long term medications, be sure to ask your doc not only for samples, but to help you be submitted to the drug companies Patient Assistance Programs for Rx medications you truely need, but can’t afford. Websites like http://www.needymeds.com/ act as information clearing houses and do an excellent job of telling you what you need to do to get on board. Also don’t be afraid to ask your doctors for generics when they can Rx them for you, as well as the local pharmacies for cash discounts, explaining you do not have insurance. Don’t let your pride get in your way or be afraid to “shop around for prices” as they vary widely and many times the chain stores (Walgreens, Walmart, Osco etc.) don’t discount as well as the local home town pharmacies.

    Keep us posted..
    Mary Wehmeier

  29. We are thinking of you Terry! Be strong.

  30. Mike Cavender says


    Best of luck for a positive result! The business needs people like you and I know something like this won’t keep you down for long!

  31. Thinking of you and hoping the hospital has wireless!!!!

    May you have a speedy recovery,


  32. Prayers for the best,

  33. Good luck on a speedy recovery. Hope they give you some good drugs.


  34. Hi Terry,

    The odds are that you will confront and overcome these physical demons.

    Then the greater opportunity opens up: How do all of us use this spontaneous outpouring of love and support to create an overwhelming mesh of interlocking pledges to reinforce each other in trials like these?Our health care system has been hijacked by lawyers and accountants while the Doctors were overwhelmed with their urge to be helpful (I’m married to an M.D.).

    Please, Terry, get well quick. Then lead us out of this wilderness. No pressure though.…. 😉

    Alan Kay, paraphrasing Leonard Sweet. “It’s easier to invent the future than predict it.”

  35. Terry,I always appreciated your knowledge and assistance when I was working on the RTNDa Communicator story on podcasting, and I made your blog a regular stop. Just wanted you to know you have my best wishes and hopes.


    Eric Deggans
    Media Critic
    St. Petersburg (Fla.)Times

  36. Terry,

    As a “hat-wearing member” of the Media Bloggers Association we are all with you in spirit and praying for your and your lovely my wife. Both I and my daughter send our love and best wishes.

    I drained the MBA rainy day fund and will get the word out to members.

  37. Terry — I met you in Nashville. My thoughts and prayers are with you, and i’m putting a little something in the tip jar too.

  38. Get well soon. I pray the Almighty for your well-being and I hope you will recover without much stress.

  39. Get well soon. I pray the Almighty for your well-being and I hope you will recover without much stress.

  40. Good luck with the surgery. I’ve been in the position of having to have surgery, twice, with no insurance. Actually, the second time, I did have insurance, and was about 2 months away from the pre-existing condition rider expiring when I got sick again. Strangely enough, I now work in the billing department of a Hospital. Tennessee hospitals are now required to give at least a 25% discount to self-pay patients. You could get more probably. We’re now actually giving price quotes to people who are self-pay.


  41. Surgery can be very expensive without insurance. In the long run it is worth even having a low health insurance plan because it will save you thousands of dollars in the long run if anything happens to you. In the state of California company’s such as Blue Cross and Tonic offer great rates.

Speak Your Mind


This site uses Akismet to reduce spam. Learn how your comment data is processed.