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Here is your answer. A surgeon does not make his living by counceling patients. He submits a small bill for time spent. The surgeons livelihood is made in the operating room performing proceedures. Now the mastectomy and lymphadenectomy or the quadrantectomy with axillary node dissection is a part of the continuum of care and this has a different billing code. I will grant the author that the compensation has dropped over the past 10 - 12 years but we are not yet destitute.

I will add that it becomes dangerous for the public to have people with a licence to practice medicine and privileges to perform major invasive surgery who are financially 'strapped'. I have seen those people perform proceedures which were unncecessary, or spread out a breast biopsy which was positive and a followup mastectomy more than 14 days later because the government would not pay for 2 proceedures within the 14 day period. That is unconscionable, but it happens all of the time.

There are much worse things going on out in the country that are winked at by the medical establishment.

Most health cost perversions are done by the hospital. 1 aspirin - charge 5 dollars. 1 box of Kleenex -17 dollars. and on and on.

All of this is leading to a 17% medical share of the gross domestic product. That is unsustainable. I have been in the buisness since 1975 and have seen many changes. The changes to come under Hillary will be made, they will be extremely detrimental to health care provision to the public, and once accepted will never be turned back to the free market forces which should determine hospital costs, physicians fees. The governments micromanaging the health care industry has lead to harsh developements in the delivery of health care to patients with many unintended consequences. But, the road to hell is paved with good intentions.

1 aspirin - charge 5 dollars

These charges are not (obviously) to cover the cost of the asprin, but to cover the overheads and costs of the 60% who don't pay. Not that I think it's a good thing, but hospitals are not allowed to turn anyone away. Case in point, Ambulance picked up a bum (heavy drug and alcohol user) with some lower limb problems. when they got him to the ER they took off his shoes and his feet came with them. He had basically dead legs and the maggots were eating their way into his lower abdomen. Both legs amputated. Urology called because of invasion of urinary bladder and surrounds by cellulitis and maggots. Guy went into intensive care and died several days later.

This doesn't even look at the Mexicans who get their "free" health care at the expense of the rest of us. Everyone who pays their bills picked up the tab for this guy. The problem is that too few people pay for too many indigents and deadbeats Health care is a commodity, not a right.