The fact is, there is very little US citizens can do as individual consumers of health care. Costs are kept elevated by forces beyond our control. We can "self ration" (i.e. forgo some non-critical medical procedures), but at the end of the day we have very little bargaining power, either with the insurance companies or with the doctors and hospitals, for the services we need.

So what is a cash-strapped patient to do? In a word, leave.

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