David,
So if I have 100 indigent patients with Medical Assistance who need colonoscopies, then it will make me feel better to charge each one $500 and write-off $375, rather than just charging $125?
I suppose that I no longer base my sense of worth (and the value of my work) on either my fee schedule or what I am paid.
A school teacher could submit a bill at the end of each school year: "For services rendered, my charge is $100,000". Does that somehow change things if the salary is still $40,000?