Hi, Physicians and other care providers have developed unique relationships with insurance companies. Private insurance is the American way through which people obtain medical care. However, as a private business insurance companies care about costs and profits, not medical care. Physicians have learned that while they must accept insurance to obtian patients, they cannot charge their direct costs to insurance companies because insurance companies will not pay the full amount. The only way physicians can obtain the full market value their services are worth is to charge insurance companies more than the fair market cost of their services. Normally, insurance companies will only agree to pay up to a certain "reasonable cost" for services. In order to ensure that physicians earn a profit and cover the cost of their work, they normally charge more for those services so that the percentage the insurance company agrees to pay increases. As a result, however, this means that insurance company costs increase and they pass those costs on to patients. In this way the physician earns a fair payment, but insurance companies then raise the rates of the insured and, the insureds, with little other options for medical care in the United States, must pay higher fees and often obtain fewer services.