Next Moves?

I am now sunk in the morass of the U.S. health care system, the little matter of the $21K bill from the doctor who worked on the aneurysm. She is an "out of network" provider, even though the hospital that employs her is in network. I wonder if the new legislation requires that if a hospital is in network, all doctors who work out of that hospital must also be in network. Anyway, in talking to the doctor's billing arm today, and following the guidance of the recent NYT article on unexpected or uncovered hospital bills and my health care provider, here is where I got -- nowhere. At one point the exasperated New Yorker with whom I was speaking asked, "What do you want from me?" I said, "I want to pay less than this bill." She said, "Have you filed an appeal with your insurance company?" Well, no, I haven't since the company's basic approach was we paid, the dr is out of network, you try to get them to accept what we did pay as payment in full. So, to sum up, the insurance company points to the dr -- at least the dr's billing office (and that's fair enough. As the dr was working my aneurysm, the last thing I would have wanted was her mind wandering to billing issues of her patients.)-- and the dr's billing office person, fed up with me, points back to the insurance company. At least she said she would annotate the account so it will not go to collection. Or at least again, it should not go to collection. But I suppose if all appeal fails, the bottom line is this, would I rather be dead or would I rather work out a payment plan for $21K. I think I have the answer to that.