I worked for a plastic surgeon doing so home improvement/handyman BS at his house and had some candid talks about medical billing. he told me this long ago. he would tell me that he grossed about 3.5mil a year but only got paid for enough to make 2mil. I asked if he was upset about the lost 1.5, and he told me no, because it was a write off, so he ended up paying very little in taxes. same thing goes on with hospitals, so never feel bad about unpaid medical bills. the bills are fraudulently high.