How could the same knee surgery cost $5,000 when performed by one surgeon, and $25,000 by a similarly trained surgeon only a few miles away? More importantly, how does the average medical consumer make sense of this discrepancy? He doesn't.
To be sure, many conditions require surgery, and surgical procedures have contributed to important increases in longevity and quality of life in industrialized settings. But the few sham surgery trials that have been done have likely uncovered the tip of the iceberg.