There are regulations that prevent a doctor from discounting. Discounting one patient, you see, means that he's "overcharging" the insurance companies . The HMOs and others would then have the means to cut his fees to the discounted rate he gave you, which would surely drive him out of business when they then take their cut out of the lower fee! Medicare is particularly sticky on this...you can't even deal in the kind of transaction at all with someone over 65, or the doc risks being cut out of Medicare altogether.
They call it "fraud" and it is certainly absurd and unfair. But you're talking rich greedy doctors..
in days before hmos, and all the other cost increases, medical visits were much cheaper. the most competent people in society are the most productive. these are the people who are able to produce the miraculous advances that save lives today. they are the surgeons who steal life back from terminal patients etc. daily. if you dont think what they do deserves compenstation in terms of a free market, which this ceased to be long ago, then remove all the artificial costs which lead to the inflated costs of today.