There are tons of better ones.

I have to believe that the doctors time was worth more than 4 cents. Or barring that, I can't imagine any company that would bother to ship a medicine that earns them a gross of 4 cents, with a profit margin of maybe 2 cents. Instead they would just exit that business and then no one would have that medicine.

In fact, using this would in theory make a better case that healthcare cost should rise. We know that's wrong however and that's why the author point, while accurate is using a bad case study to make it.

BUT ... if it's $20 for JUST for the dose of lidocaine, it's a bit ridiculous. That'd mean they're charging patients $100 per 50mL bottle. That's absurd, the stuff is dirt cheap and is also sold in MASSIVE quantities worldwide. Probably costs the doctors office $5 at most I'd bet.

2 - Surgery rooms and staff are separately charged
3 - 4 cents is what the insurance company negotiated. It probably came from buying it in bulk and figuring the cost of a single dose

Just about every medical procedure and post care are mandatory a la carte. I know somebody whose spouse recently died after a lengthy hospital stay. That person used to work for the insurance company and had high level contacts who looked into the case and pulled strings on their behalf. The patient had separate insurance for retirees that covered most of it. The surviving spouse was still driven crazy every few days by new mailings and phone calls to get it all sorted out.

This country desperately needs an overhaul of our medical system.

In fact, it may already be moot with the current conservative majority and we don't know it yet. Various cases are headed for the high court right now.

The people the Republican leadership serve have no intention of allowing single payer if they can stop it, irrelevant whether it would be as the planned extension to the ACA or part of a whole new system. And they intend to destroy the ACA as they've always promised. You know, anti-tax, anti-regulation wealth united with the God's kingdom folk?

Some braver reporter might bring that up with trump.

won't be held responsible for the other $19. In all likelihood, the Lidocaine will be considered included in the payment for the injection.

That's true under Medicare, Medicaid and most insurance plans.

There are other reasons for single-payer, but that is not one of them.