Another part of the medical billing scam is the difference between the medical billing charges and what the insurance company negotiates to pay. Here's an example. A few years ago I had three small lipomas removed from my arm by a plastic surgeon. I paid a $30 co-pay. When I got the summary of the costs from the insurance company, I was amazed. The billed amount by the plastic surgeon was $800 per lipoma or $2400 total. (The entire procedure took at most 20 minutes so that's a pretty good hourly rate!) However, the negotiated rate that the insurance company paid was $200 per lipoma or $600 total - a 75% discount! What boggles my mind is that if I did not have insurance I would have had to pay the full $2400 for a procedure that the surgeon is apparently happy to receive $600 for. Every billing summary I've ever gotten is similar with discounts for exams, bloodwork, procedures, etc. being typically 75% - 95% over the billed rates. So if you don't have insurance you're not only screwed by having to pay for everything yourself, you also have to pay 4X as much as the insurance companies. How much longer can this go on before the entire system implodes?