This is not a single payer diary, but it does provide insight into some of the problems Doctors face and is worth clicking over to read the entire piece:

When the insurance company is the middle man there is a drastic decrease in what the physician is paid. For example, in a former HMO contract I was getting 18 cents on the dollar. I have since negotiated better contracts and now receive almost 60 cents on the dollar in my highest paid contracts. However, In order to make up the short fall, the pressure has been to either see more patients or raise my prices. If you contrast this with a specialty that does not take insurance it is easy to see what has happened to the cost of care for the patient without insurance. For example, in plastic surgery - the price for a rhinoplasty or a face lift has essentially remained unchanged over the years because they are strictly fee for service. I had two choices to keep my doors open. Either see 50-60 patients per day, hire a physican assistant or a nurse practitioner and become a 'mill' or adopt electronic medica records, electronic precribing system, practice wellness and prevention. I chose to do the latter.

In short, the cost of medicine has risen because of the insurance companies and their effect on the cost of medical malpractice. The increase in premiums paid by patients have not gone to pay for medical care, but instead has gone to the insurance company in CEO bonuses and investments in software and/or gatekeeper physicians and nurses who get bonuses for rationing healthcare by denying necessary procedures and tests. I can give you plenty of examples of necessary medical care denied to my patients by a nurse making clinical decisions. The insurance companies have developed an elaborate system designed to pay as little and as late as possible (over 1 year after service in some cases). There is little oversight or regulation of this industry and physicians have little recourse. For example.