Some of the expense is due to supply and demand of course, an age old problem! Then there is the Trickle up effect: everything from the cost of a band aid to the electricity bill trickles upward to the patient! If a band aid cost the manufacturer 1 penny to make 1 band aid, the manufacturer charges the wholesaler 5 pennies for the band aid and the wholesaler sells it to the doctor for 10 pennies. Next the doctor charges you 15 pennies for it! It is the same for everything in the office. Now you have the cost of the building and utilities, the doctor charges you a percentage of that, you get charged a base rate for the doctors time, a standard amount for every 15 minutes you take! The next problem you deal with is the set amount that insurance companies agree to pay the doctor. It is always less than a cash patient pays. So the doctor loses money on insured patients many times. Especially those on state paid insurance programs like Medicaid and Medicare. Now lets add to that litigation malpractice Insurance. Who do thinks pays for that? We do of course. All of the loop holes found to keep insurance companies from paying their bills, trickle up to us, all of the loopholes the government can find also trickles up to us! Aren't we the lucky ones!