Keep in mind that cash customers can also ask for, and usually receive, a significant discount. I doubt it's as much as the write-off you noticed, but it's still significant.
When I had a stroke back in July 1995 I didn't have insurance. It was our fault, we decided not to cover me because at the time my husbands work would only pay for the employee and we had to pay the whole amount for dependents. Money was pretty tight but even though we didn't have a lot of extras we could cut some expenses and we could have barely made the extra payment. We decided to only cover the kids and leave me off the insurance....we thought that nothing could happen to me as I was only 27 at the time my husband started his job (March 1994). Our plans were to wait awhile and save some money then add me to his insurance at next yearly insurance renewal. Unfortunately for me I had the stroke before the insurance renewal came that year (the year we planned on adding me). We gambled and lost but we were young and stupid at the time.
The doctors who saw me at the hospital wouldn't write off anything at all. It took us years to pay them off. The hospital actually wrote off most of the bill (all but $1000 and I had an angiogram and was in ICU for days) because we were considered "indigent" at the time (yet the doctors wouldn't write off a penny). I don't want to sound ungrateful because I remember the day I got notification that the hospital was writing off most of the bill (can you imagine how much a 7 day hospital stay with 5 days in ICU would be). I was also greatful for the great treatment I received, heck they didn't even ask for insurance until the day I was checking out of the hospital.
I had to have follow up labs and other procedures after I was out of the hospital so my doctors held off on tests for as long as they could and would only order one at a time to give me a chance to pay off the previous test before they ordered a new one. I had two doctors after I was out of the hospital and back home in Dallas (I had the stroke in Lincoln Nebraska), a neurologist and a rheumatologist, one saw me for free (neurologist) and the rheumatologist would always mark it down as a level I visit instead of the real level it was (they were always in depth visits). Most doctors will work with you if you don't have insurance but there are some that wont. Also the doctors at the hospital I had my stroke called my neurologist and told him I didn't have insurance and asked if he could see me and he accepted me anyway (most likely because I had a freak disease that they hadn't seen before). My neurologist asked my rheumatologist to accept me as a patient and I'm sure he was excited to see someone with a rare disease as well (both doctors had never had a patient with my disease: Takayasu's Arteritis).
So I have experienced health care with out insurance and I can tell you that my life revolved around figuring out just how much I could send out every month on health related expenses while leaving enough left over to pay the bills and have food for my family. It's not fun and I don't want anyone to have to live like we did at the time. Lucky for me when my husbands insurance renewal came around they had to take me because I was considered part of the "group". Money got really tight then because not only were we paying off doctors and other medical expenses, we also had the added expense of my insurance premium. I started watching kids to help pay the bills (I could have gotten on disability had I been working at the time of my stroke), I don't think I could do that today if it all happened to me at the age I am now...it was hard. I had a raging case of Takayasu's and on high dose prednisone (60 mg), monthly doctor visits (sometimes weekly depending on what medication I was on) but I did what I had to do to help pay the bills. My husband would come home from work to take me to the doctor and we would just take all the kids with us to the doctor. It was a sight to see.... LOL
