One thing that's especially egregious about the situation in RadOnc is that there are plenty of situations where the doctors and physicists have already planned

One thing that's especially egregious about the situation in RadOnc is that there are plenty of situations where the doctors and physicists have already planned a treatment, billing $xxx per hour, and only then it is denied by insurance, so the hospital counts this as a loss and plans another inferior treatment, increasing the cost, in order to offer a "cheaper" procedure as demanded by the insurance company. The losses are of course amortized to drive up the cost of all treatments while the patients are given inferior care. It's absolutely infuriating. A friend who is a therapy physicist left the country and went back to work in Canada taking a 40% pay cut because he couldn't stand it anymore.