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The 800 patients about to open letters from Dr. Emily Gottlieb asking for a $300 annual practice maintenance fee should be outraged by Bruce Japsen’s story. Although in the story Gottlieb complains about an $18,000 hike in insurance premiums, simple math shows that she’s trying to squeeze an extra $240,000 out of her practice to cover it. Gottlieb is using insurance hikes as a convenient excuse to gouge her patients. She would be better off asking the Department of Insurance to investigate her insurer’s premium-setting and financial management.