You pay much more. There's a lot of reasons why, but one is that insurance companies require ridiculous amounts of paperwork to be filed and it costs a lot of money to process it. I have a doctor that doesn't take insurance and works for himself. Because he doesn't have to pay for all of the secretaries, it is a very cheap visit. He's not a surgeon, but same idea. Also, hospitals are required by law to help everyone that comes through their doors, including those who don't have insurance or a means to pay. Just imagine what kind of costs that tacks on to our bills? I have seem numbers in the billions per year at a single hospital. It's obviously a complicated issue, and I don't claim to be an expert, but the answer to your question is definitely: we pay way more.