I know. Blah blah blah. Obummacare, socialist, job killer.

But seriously, when you take your car to the garage, would you let them get away with such exorbitant charges for a ping in your engine block that they did virtually nothing to fix.

What am I paying for? Labor?

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That urologist spent 20 minutes coding in "quality metrics" for your five minutes with him. He spent another ten reviewing any lab works and/or records.

Your $147 paid his overhead, the salary of the person he had to hire to do the paper work for your insurance ($20 an hour) the nurse to take your vitals ($28/hr) the receptionist to set your schedule ($15 an hour), the electronic record he does not want but was forced on him ($150000 a year) his medmal. ($120000 a year) plus all the other overhead required which, on average, adds up to about $200 an hour.

And, as was said below, he did not set his fee, the federal government told him what he should charge.

$147 dollars? If he has been absorbed into a hospital based system as encouraged by the ACA then you paid double a private doctors fee because the corporate practices also charge "facility fees" under the ACA.

The mechanic doesn't have to spend hundreds of thousands of dollars to become what he is, he doesn't have to wait until age 33 to begin working, he doesn't have to be woken up in the middle of the night for silliness ... Or emergencies. He has nowhere near the amount of government regulation that forces him to increase overhead. And he doesn't risk losing everything he ever earned in a single lawsuit.

Whenever I have someone complain about my fees I tell them they don't need to come to me if they don't think I am worth it. I am not forcing them to make appointments.