[ceejayoz]

That has at least one fairly simple explanation: those centers only take lower acuity patients. If you're complex with a history of complications, it'll be "we'll do this one at an actual hospital".

(This is frequently the case for my wife.)

They may also not take Medicaid patients; my state publishes lists of ones that actually do because of this. https://www.health.ny.gov/health_care/medicaid/quality/surge...

[tptacek]

Right, I know that surgical centers operate with a variety of important limitations (surgical centers as they exist now are not an answer to the US health spending problem, which I preemptive agree is very real). I'm just saying that they're evidence of an at least semi-functioning market; they couldn't exist without that (who would send pts to them otherwise?).

[ceejayoz]

That some pieces of the healthcare market may function is something we can all probably agree on. But /u/Sparkle-san was clearly speaking about something broader than these individual exceptions from the rule.

(And even in the case of a surgical center, your decision is likely to be significantly impacted by who your insurer will agree to cover.)