The idea of cash negotiation for medical care came from a physician friend. While antelope hunting a few years ago, we got in a discussion about healthcare. He encouraged me to start a health savings account. I had to do some research, and I had to get over the “MDeity anxiety” that prevents most patients from trying to negotiate with doctors. But I was able to whittle down the total cost of my recent foot surgery 32 percent — a savings of roughly $2,250.