I guess we simply have different experiences.
Both my PCP and my Dentist actively work to save me money. And they are up front about it.
They are both established, un-affiliated with any “health care syste”, and about my age (60).
I feel bad for people who have to rely on “corporate” systems. I know when “my guys” retire, I will experience culture shock—probably at the point in my life where it will hurt the most.
There was a California proposition on the ballot 25 years ago that failed. It would have allowed hygienists and other lower level professionals to open their own offices. People such as legal secretaries filling out forms for clients or RN’s serving patients for more minor ailments. No you had to have the high level pro come in for a couple of minutes and call the shots. Just think what they would do if they needed the referrals from these people. I tell you man it’s fixed. Perhaps dentists should only be allowed to diagnose or treat patients, not both.
Los Angelodes(Yuma) has 500 dentists. Like here you have to shop.