Subject: Re: healthcare
Is your wife in a practice that has staff to manage some of that paperwork load?

No. She is a solo.

Add that to the cost of health care- as well as the correlative staff in the insurance billing department that processes claims.

Physicians and other care providers in the United States are only the tip of a mighty long and hefty spear, and the costs of that long and hefty spear add up, and they also include the cost of stratospheric upper management salaries- stockholders as well, and big fancy corporate headquarters

This is with Medicare, not private insurance. It was (and now is again) a constant struggle with them to get the claims paid. The private insurers are much easier to deal with.