Thanks for the excellent example. It cleared up some of the confusion I had about billing and negotiations between providers and insurers. I know a couple of doctors against a rapid transition to single-payer, at least in the sense of moving everyone onto Medicare. They claim that Medicare disbursements are insufficient to cover the total cost of care (for the provider's clinic as a whole), and that a sudden switch would drive a bunch of practices out of business. I guess what I've never seen answered is, how would single-payer care make sure that healthcare professionals receive reasonable compensation? Or maybe the answer's hidden in your example and I missed it. For the record, I think that single-payer would at least solve the biggest problem, which in my mind is insurance companies gouging people and forcing an artificial price hike on every single line item.