It looks like you have some good questions there. Hope your research proves fuitful and you find all those answers.

Well, pdq, I asked you because as chief bloviator (or perhaps bloviatrix) here you seem to have all the answers.

I do know this. Several years ago I had my eyes 'done' (cataracts removed). As you know, in such cases they normally only do one eye at a time, starting with the worse one. About two years later I went back to have the other one done, as it had worsened in the meantime.

A day or two after the operation, I went back for a follow-up, and happened to look over the receptionist's shoulder at her computer screen as she checked me in, and I saw that my HMO had not even paid for the first one yet, two years after the fact.

She made no mention of it, and later I was told that the doctor was probably a partner in the HMO so, in a sense, he had not paid himself and no doubt some adjustment in that direction would be made eventually.

I don't know if this is common practice with HMO's, I thought perhaps you knew.

Why could the insured not form similar co-ops, insuring themselves in much the same manner as the doctors? Sounds like a deal to me.