How To Negotiate 80% Discounts Off Your Medical Bills

Click the link below for details. It’s a long article but could save you thousands of dollars unless you’re covered by one of the semi-socialized health insurance schemes like Medicare, Tricare, or Medicaid.

The author knows what he’s talking about. The only potential error I found is where he says federal law requires every U.S. healthcare provider must always charge the same fee for each specific service (CPT code). In other words, they can’t charge one person less or more than someone else. As far as I know, that only applies to Medicare (and Medicaid?) patients.

If you buy a lot of healthcare services, you must read this article.

In a nutshell, the author does this when he needs non-emergency services:

Here we go, step by step:

1) I usually prefer to skip the added expense of going to a GP or family practice intermediary just to get a referral to a specialist that can actually help, especially when I can determine what medical specialty is likely to be most helpful for by medical condition by visiting the website of the American Board of Medical Specialties.  (Is your ignition system acting up, your suspension riding a little rough, need new tires, brakes squeaking, transmission grinding?)      

2) Use the links on to visit the appropriate specialty board’s website, and then use their “find a physician” with the sub-specialty likely to be most helpful for the condition.

3) Start calling the sub-specialty physician offices listed, tell them you are a prospective new patient, and ask to speak to the Business Office Manager.  Ask him or her the following questions:   a) “Do you accept Medicare and/or Medicaid insurance?”  If yes, then…   b) “Super!  Do you accept cash payment at the time of service?”  If yes, then…   c)  “Great!  Then, of course, you will accept as payment in full, the Medicaid allowable, but paid in cash by me to you, directly, at the time of service?  Correct?”  If yes, then (e).  If no then (d).   d) “I guess I understand.  Well, then surely you will at least accept as payment the Medi­care allowable, paid in cash by me to you, directly, at the time of service?  If yes, then (e).  If no then conclude the call, because you cannot fix stupid.   e) “Thank you!  Can you please tell me what the estimated amount is for an office visit, using this fee schedule, so I can know how much money to bring, and please make a note on my account that we have negotiated a Single Case Agreement for me to pay these rates to you, in cash, at the time of service?   f) Tell him or her your specific reason for the visit (I am leaking red fluid on the floor of my garage) and that you want to be fully prepared for the visit.  Ask what diagnostic tests, if any, are usually required for this type of problem, lab, X-ray, CT, MRI, ultrasound, etc., and which ones would probably need to be done outside the physician’s clinic?    g) Make sure to get the business office manager’s name and contact information, and the appointment time and date.

Source: How to negotiate directly with physicians and hospitals. | Zero Hedge | Zero Hedge

Nuttin’ But Salads N=1 Experiment: Week 5 Summary

Hard to see the bed of leafy greens

Weight is down to 164 lb (74.4 kg), having started five weeks ago at 175.5 lb (79.8 kg). So 11 lb in five weeks. Not bad!

I didn’t buy this at Costco but it looked wonderful and would easily feed two. Great deal for the price. Costco has good prices on salad greens.

My compliance has been good except for tonight when my wife and I ate at The Keg steakhouse. I had arctic char (my first time, tastes like salmon), creamed cauliflower, roasted l0w-carb veggies, sourdough bread, 6 fl oz red wine, and Billy Miner Pie (mostly mocha ice cream). My weight should be up a couple pounds tomorrow.

Before: My wife found this at Domino’s Pizza. Surprisingly good and fresh, for $5 USD. One small meal.

After mixing

I still haven’t done nutritional analysis of my meals. Wouldn’t be surprised if I don’t meet the RDIs for calcium and vitamin D. I haven’t spent much time in the sun this winter.

The chicken breast on this was prepared sous vide style with Montreal steak seasoning, then pan-seared

My waistline is an inch narrower. I still can’t see a six-pack so I think I’ll keep on the Nuttin’ But Salads diet for now, adding a multivitamin and vitamin D “just to be sure.”

I like this Newman’s Own dressing. First ingredient is olive oil blend, unlike most commercial vinaigrettes that first list water or canola oil. Pour spout is messy, but I can live with that.

I feel good and my workouts are going well w/o reduction in performance.

One of our favorites

Do the eggs make you think “breakfast salad”? I gained a couple pounds after eating this cheese-laden meal, and then did a 24-hour fast.

Steve Parker, M.D.

Another Example of Corruption and Collusion in the Medical-Industrial Complex

“Patients frequently paid more for drugs through copays than the cost of those medications to insurers or pharmacy benefit managers, a research letter in JAMA indicated.”

Source: Over 20% of Copays Exceed Actual Drug Cost (JAMA) | Medpage Today

Does the Mediterranean Diet Really Prevent Chronic Diseases?


Told ya so!

A couple PhD nutritionists with the University of Arizona Cancer Center reviewed the literature in favor of the healthy Mediterranean diet in 2017. They agree with me that the health claims hold up to scrutiny. From the abstract:

A large body of research data suggests that traditional dietary habits and lifestyle unique to the Mediterranean region (Mediterranean diet, MD) lower the incidence of chronic diseases and improve longevity. These data contrast with troubling statistics in the United States and other high income countries pointing to an increase in the incidence of chronic diseases and the projected explosion in cost of medical care associated with an aging population. In 2013, the MD was inscribed by UNESCO in the “Representative List of the Intangible Cultural Heritage of Humanity.” The 2015–2020 Dietary Guidelines for Americans included the MD as a healthy dietary pattern. Therefore, specific objectives of this article are to provide an overview of the nutritional basis of this healthful diet, its metabolic benefits, and its role in multiple aspects of disease prevention and healthy aging.

Source: Mediterranean Diet and Prevention of Chronic Diseases

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one


Brief Review of P.D. Mangan’s “Best Supplements for Men: for more muscle, higher testosterone, longer life, and better looks”

Death in a bottle?

Best Supplements for Men was published in 2017 so should still be up to date. I have the paperback but it’s also available as a Kindle e-book. Per’s rating system, I give it five stars (I love it).

*  *  *

My favorite sentence in this book is, “If you don’t eat, exercise, and sleep right, the health effects of adding any supplement may be minimal to non-existent.” That sets an honest tone. Also in favor of integrity is that the author doesn’t offer Mangan-branded supplements for sale.

I like this book. I learned a lot from it. I’ve benefited by reading the author’s tweets and blog (Rogue Health and Fitness) for several years. He’s smart and, I believe, honest.

The author supports his assertions with numerous scientific references, organized by chapter at the back of the book. If he cites a study done in mice, he tells you. Human studies admittedly carry more weight.

Have you wondered if protein supplements and creatine are good for muscle strength and energy? Does magnesium increase testosterone levels? Does berberine have beneficial health effects? The answers are here.

The author gives good advice regarding calcium supplements that even most physicians don’t know about.

Great recommendations on food.

No book is perfect, and this one is no different. It has no index. So if you’re curious about turmeric or supplements that control diabetes, you have to scan the whole book. My copy didn’t include references for chapter 11. Page numbers for chapters in the index didn’t match the actual chapter starts. My least favorite sentence in the book was something about Dr. Joseph Mercola being a trustworthy source of health information; he is not (search “mercola” at

Again, I like this book, learned much from it, and recommend it to men. If you’re taking lots of supplements now, read this book to find out if they help, harm, or are only good for making expensive urine.

Steve Parker, M.D.

PS: Some personal notes from my reading. Many of the cited studies are “association”-type evidence  rather causation. Berberine may help reduce blood sugars in diabetics just as well as metformin. Creatine: Yes, for muscle growth and strength. Magnesium 700 mg/day increases testosterone. Mag oxide may be worthless due to poor absorption. Mangan likes mag citrate but Lexicomp says it’s no better than oxide; absorption “up to 30%.” Citrulline: Yes, for ED, and may help with HTN. DHEA 50 mg/day increases testosterone in men by 50%, but only in men over 70. During fat weight loss, whey protein helps prevent muscle loss. MCT oil may also help (e.g., cook with coconut oil). ASA 81 mg/day seems to prevent some cancers in folks over 55, especially colorectal cancer.

Nuttin’ But Salads N=1 Experiment: Week 4 Summary

Mixed greens, cheese, walnuts, sous vide chicken, mandarin orange wedges, dried cranberries

My weight is down to 165.8 lb (75.4 kg), compared to 167.4 lb (76.1 kg) last week.


I feel good. Workouts are going well. No muscle cramps. I’m feeling a bit chilly much of the time, but that may be because winter finally came to southern Arizona.

Found in the hospitalist office. Not a salad. Didn’t eat any.

I’m eating two big salads a day and that’s it. Remember, I’m relatively sedentary so don’t need lots of calories. If I had a physical job, I might need to eat more often. I’m not bothered much by hunger or temptation. I wonder if I’m in ketosis. Perhaps proper mindset is a large part of my success.

I’m starting to wonder if I might eventually see my six-pack abs. They’re in there. Under an inch of fat.

 Steve Parker, M.D. 

Omega-3 Fatty Acids Linked to Lower Multiple Sclerosis Risk 

Dead whole fish aren’t very appealing to many folks

I’ve been telling you guys for years to eat cold-water fatty fish twice weekly. To protect your heart. Now we have another reason…

“Omega-3 fatty acids may play an important role in lowering the risk of developing multiple sclerosis (MS), researchers suggested.Consuming fish at least once a week — or at least once a month with regular fish oil use — was associated with a 44% reduced risk of MS or its precursor, clinically isolated syndrome (CIS), reported Annette Langer-Gould, MD, PhD, of Kaiser Permanente Southern California in Pasadena, CA, and co-authors, in an early-release abstract from the American Academy of Neurology annual meeting, to be held here in April.”

Source: Omega-3s Linked to Lower MS Risk | Medpage Today