Emergency rooms were especially lucrative because people didn’t shop for ER care; they just went. Many hospitals, especially small ones, contracted with ER doctor staffing companies because staffing their own ERs with their own employee-doctors could be so daunting: you had to hire four or five to run a 24/7 operation, and pay their salaries and benefits. And so people often wound up going to a hospital that was in their insurer’s network, but whose ER was staffed by doctors who were out of network. Out-of-network doctors were not held to a contract price—they set their own prices, at an
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