Just a thought:  the next time you are going in to the clinic or hospital for a procedure or test, ask the provider a simple question.  “How much will this cost?  May I pay for this myself, and will you give me a bill before I leave?” Be prepared for the blank stare that will come at you, like you just dropped from another planet.  Just think about taking your auto in to the shop and they will tell you that the cost/price will be determined at some later time, but you will be obligated up front to pay whatever that may be.  Hmmmmm