I'm sure there are specialists who make $600k a year. At least around here, primary care docs make around $200k max. Even if they're making $600k, that doesn't even begin to explain why hospital costs are so high. Some napkin math says $600k/year, 52 weeks/year, 40 hours/week is about $288.46 per hour. If you spent 10 hours that day with a very highly compensated doctor, that's less than $3k. So where does the other 5k of that bill come from?