The problem for me is emergency care is where I’ve easily spent the most healthcare dollars.

Providers already treat you with disdain and the back office in most doctors offices can hardly function as it is. When you ask how much something will cost, you will get somewhere between a blank look - if you’re lucky - to outright disgust that you could ask such a pedestrian question. You wouldn’t understand how complex medicine is and what could happen, you pleb. So how could we do something like give you a dollar amount?

I think you might be taking it a bit too personally. I live in New England, and people are very blunt and straightforward here. I've gathered, asking if certain things are covered, that the office staff (and even moreso the providers), genuinely have no idea how any of this shit works. People are to the point here, so some of them will tell me as much, and I learn it's pointless to ask those questions at time of care. Wait for the garbage to go into the system, garbage comes out, and then we can maybe talk... Because this is totally how legitimate businesses operate, and bears no resemblance to how the mafia would determine what you owed in protection money. But arguing with the front desk staff would be rather pointless. You just go along with the madness, just like citizens of the USSR did when everything was falling apart around them, and hope the whole thing crashes and burns sooner than later.

In other parts of the country, people are passive aggressive and it's extremely annoying. They won't admit they don't know, because it's all about appearances. Patients faced with such responses would become irate. What do you mean you don't know?! The workers hate themselves for not knowing, and they know this whole thing is a scam even better than you do. They hate themselves for participating in the scam, and so the cognitive dissonance manifests as rudeness towards you.

Believe me, these people don’t give a shit. I am well aware of cultural differences across regions. They see your meddling questions as just another annoyance in their day and the faster they can get you to go away the better. 99% of their patients don’t know to ask, so you are just seen as a pedantic pain in the ass.

Your point of cognitive dissonance is an interesting one. But ultimately it doesn’t matter what their state of mind is; if you are treated badly as a patient you will just give up to save your own mental energy. After all you’re seeing a doctor because something is wrong already. Why am I layering on managing the precious feelings of the doctors back office personnel on top of all that too?

No one is perfect, and too often, stress makes people behave in ways they're not proud of. That's mostly understandable. But I think you're vastly overstating the mental burden of trying to be kind and having a bit of empathy in general.

Why bother? Because they're just working stiffs trying to put food on the table like the rest of us. They're not responsible for the existence of this detestable system any more than you are.