I recently had skin cancer surgery. I was offered a 20% discount to self pay. Because of my deductible I would have paid more if I used insurance than if I just paid. We are now to the point where it's not cost effective to use our private insurance for cancer surgery. How anyone is defending this system is crazy to me.
My wife had a kidney transplant. Two of her medicines cost hundreds each per month with insurance, but without insurance are under one hundred each for three months.