There's been a lot of talk lately about the practice of balance billing, especially in California. Balance billing occurs when a doctor charges more for a service than an insurance company is willing to pay, and thus the doctor charges the patient (illegally) for the balance. While I certainly believe that the practice is unethical if it is prohibited and patients don't know any better, is it really that unfair? Doctors put a lot of work into doctoring... shouldn't they be properly compensated? Should they really be just barely covering the costs because people buy small insurance coverages or because Medicare/HMOs are too stingy? In the case of a patient in need of emergency care that the insurer wouldn't cover, balance billing is unethical. Agreed. But what about otherwise? Nobody seems to be pissed at their insurance company for this... just at the doctors for being audacious enough for asking for what they charged. It's tantamount to paying a $1 for a $5 loaf of bread and saying that you really needed it, so the store should just give it to you. This never happens with other professionals - could you imagine winning a court case (like having a successful surgery) and not fully paying your attorney what he was due? Dr. Atul Gawande, author of Complications and Better, has made this argument before. Maybe going into the profession I'm sort of biased toward protecting doctors from the flak they get these days, but at the very least the blame should be shared with short-changing insurance providers?