How American Medical Care Gets Priced

How American Medical Care Gets Priced Why does a hospital bill look nothing like a receipt? Why do identical services cost wildly different amounts—sometimes in the same building? In this episode of Doctor AI, Dr. Robin Blackstone unpacks the hidden architecture behind American medical pricing. Not the headlines. Not the politics. The machinery. You’ll hear how billing codes replaced judgment, how committees—not markets—set prices, and how a system designed for accounting quietly came to govern care itself. This is the story of RVUs, CPT codes, negotiated rates, and the unintended consequences of turning medical work into units of volume rather than acts of care. This episode is not about blaming clinicians or patients. It is about understanding how a pricing system built decades ago now shapes time, trust, access, and outcomes—and why real reform must start with how value is defined. Clear. Uncomfortable. Necessary.