In the days before HMOs and PPOs, deductibles and co-pays, a satisfied patient might have paid his doctor by bartering a service (such as a carpenter fixing their doctor’s creaky porch), presenting baked goods, or offering whatever cash they could muster up. While it would be lovely to barter a transmission rebuild for an endoscopy, the U.S. healthcare system doesn’t work that way. As modern and complex as today’s medical