That is something you can do in cahoots with a regular cashier and the reason places like Costco check your receipt. The cashier just has to fake scan an item, and nobody would notice. Receipt checking makes it possible to get caught.
Agreed, but there's nobody looking if you're putting the items in the bagging area or not. You could simply leave an item last, pay, put it in the bag, and go. They do have (prominent) cameras over the tills I've seen, though, not sure if that's just "we see you" or if they're doing some item recognition with that.