Think of it this way: Instead of an ER doctor, I'm a cook.
Most of my patients don't realize it, but except for university and government-run hospitals, ER docs are "cooks," working in a hospital-owned restaurant -- that's why there are two parts to every emergency room bill, one for my work and one to keep the bandages stocked and the lights on.
Let's say my specialty is steak. You come in, I cook one, you eat it. Appetite satisfied.
Now imagine we California cooks make the best steaks anywhere. Chefs from other countries come to learn here, and our restaurants are the envy of the world. For emergencies and trauma care, our ERs are exactly that -- the best anywhere, 24 hours a day every day. It might not feel that way when you are waiting four hours on a Saturday night, but it's true.
One day, a salesman from Steak-Net knocks on your door. He'll sell you a $10-a-month card that you can use when you're hungry. With it, go to a restaurant, and Steak-Net will pay for your dinner. Steak when you want it, for pennies.
How can Steak-Net afford such an offer, when steaks are $14.99 each? Well, a lot of people belong to Steak-Net, and they don't all eat steak every day. And Steak-Net restaurants are more efficient, the salesman says. From pasture to plate, Steak-Net applies "cutting-edge industrial food technology" that makes Steak-Net steaks cheaper but just as tasty and filling as other restaurants' steaks. The salesman would tell you how, but it's a trade secret.
So you join, happy to be covered by Steak-Net.
The next time you get hungry, you find a Steak-Net restaurant. It's a decent steak, and the price is right.
Then one day you find yourself on my street, ravenous -- you plop your card down: "One steak -- I'm a member!"
But my restaurant doesn't participate in the Steak-Net program, I tell you. It used to, but Steak-Net would send only $5 to cover the cost of each steak. That's what the company says a steak costs in its restaurants, so that's all it will pay. But it costs my restaurant $8 to buy the steak, $5 to cook it and $2 to serve it -- $15 total. After losing money on Steak-Net customers for a while, my restaurant dropped out.
So now when you come in, I feed you and hand you a bill. After SteakNet kicks in $5, you have to cover the balance. You owe $10 for your $15 steak.
