In birthing mal ins is so high that a substantial number of Doc's will not do OB anymore. The other factor is your ins rates are normally negotiated with hospitals and providers by the Ins company. Seldom said is providers factor in the cost of those who do not or can not pay. All over the board on where / how much with location. Hospital's absorb a huge cost in ER's as uninsured use them as primary care providers.

It is really and amazing system we have now as many unseen cost are simply passed on to those that have ins or pay out of pocket. One of the solid arguments for reform really as we already pay for it in a round about way with bunch of folks falling through the cracks.

Just for the sake of conversation does anyone know how the Hawaiian system works? They have a lot of out patient clinics that seem to function reasonably well.