Personally I think that the real devil is the insurance companies if you are self employed you better have a perfect bill of health or you are el screwbo.

I have been in medicine since the day I took my first breath of air. The hospitals aren't making the big money, the doctors aren't making the big proportions, and the nurses aren't either. The people making the money are the pharm and instrument manufactures. People can cite the R&D thing all day long but the fact of the matter is that despite all of the huge and often subsidized R&D risks have huge bottom line profits at the end of the year.

The doctors developing the surgerys are usually rewarded with some speaking engagements and their names in the text books the 15 minutes of fame while the instrument manufactures run away with the money. Arthroscopic knee surgery was developed by two doctors as time passed one of the doctors continued to teach and help patients while the other who was also a fine surgeon spent a bit more time selling the instruments. Although both are very well off guess which one is close to a billionaire.

The problem is literally going down peoples throats and in thier ass, not salaries and payrolls that knuckleheads would like to think.