Doctoring really isn't all that different in principle. The actuaries have these books and already do estimate these costs. And the overwhelming vast number of

Doctoring really isn't all that different in principle. The actuaries have these books and already do estimate these costs. And the overwhelming vast number of procedures are consistently predictable. There's a couple ways of managing unforeseen issues, the simplest of which is to pad the total with a comfortable risk margin. Or allow extra billing for emergencies, but publish rates on how often they "miss" their estimates like restaurant health codes. Right now they're not even trying.