In another thread here, I mentioned that my orthopaedic surgeon had an annual insurance premium of over $400,000.

I had some surgery in late April and the final bills are coming in. Here are a couple results...

• Northwestern Memorial Hospital in Chicago billed Medicare $49,110.55 for my room and board, drugs, OR and anesthesia, lab work and nursing care. Medicare approved payment of only $5,340. The hospital wrote off the remaining $43,770.65, over 89% of the bill submitted.
  
• My surgeon subitted a bill for $17,272 for all the pre-op and post-op appointments and the surgery itself. Medicare approved payment of only $2,512.30. The surgeon had to write off $14,760, over 85% of the billed amount.

Now tell me, how many businesses could stay alive with numbers like this? It's going to get worse as more U.S. citizens qualify for Medicare and the schedule of payments which will be authorized by Medicare continues to slide downward. It's no surprise that more and more doctors and hospitals are refusing to accept assignment of Medicare insurance, requiring patients to pay their bills and try to collect what they can from Medicare personally. My surgeon would have to perform 159 surgeries like mine just to pay his insurance premium. At about three surgeries per day, that's 53 days in the operating room with surgeries like mine just to pay for his insurance. He operates three days a week, so that amounts to 17 weeks of work--almost one-third of a year--on surgeries like mine just to pay for insurance!

He kiddingly referred to my status as a Medicare patient as a "charity case" and while he'd do his part, he can't afford to take any more Medicare patients.