I think psychiatrists do that a lot when billing for the care they give to inpatients. Four years ago, I got admitted to a psych facility. The psychiatrist told my insurance provider that he spent 30 minutes each day with me. That was nowhere's near true. On some days, no "provider" spent time with me. My insurance paid him, and I got a bill for the co payments I would normally owe. I wrote his office a note saying that I would report the bill as fraudulent, if I ever got another bill.

I gave him a specific example. One day he called to me across the dining room and asked how I felt. I said I was doing better. So he gave me a "thumbs-up" and went to talk with another patient. I told him the date and time. I pointed out that being given a thumbs-up does not constitute 30 minutes of psychiatry. I never got another bill.

For almost 3 years, I've been seeing a gastroenterology surgeon every 8 months. He is a professor at a medical school who wants to operate on my stomach. I got referred to him because I had a bleeding ulcer. Well, it healed up about 2 years ago, and I have no problems or symptoms with it. But he keeps me coming back. He keeps encouraging me to have this surgery. I keep declining because my stomach feels fine. He's got surgical residents to train, and I think he needs more patients as grist for his mill. My regular endocrinologist says he thinks the operation would be overkill. So I'm not just being stubborn.

Healthcare inflation is one of the biggest drivers of the increasing cost of living. Most healthcare bills are paid by 3rd parties, so consumers don't provide much pushback. Plus, medical care is often thought of as a necessity. Plus, we get referred to specialists, who hold onto us way longer than they used to. Specialists, today, keep their calendars full by keeping many of their patients on perpetual "follow-up" visits, even after the specific problem has been sufficiently dealt with.