Lost in the World

  No wonder people succumb to senility, or Alzheimer's, or dementia, or whatever you want to call it.  For a person used to thinking and at least gaining a minimal understanding of how things function, living in a world where explanations exist is no longer possible, at least for some of us.  I'm not referring to trying to gain a rational explanation of human behavior, which is and always has been based on whim and fancy and ambition and such.  I'm talking about regulated practices and standards and cause and effect and precedents.  We joke that we need lawyers to untangle legalese, the language intended to obscure interpretation.  But it's not really comical when you think you should be able to grasp a concept but realize you lack some piece that prohibits comprehension. For example, medical billing:
    I know healthcare, Medicare, Medicaid, Obamacare, Hillary-care, and all that preceded present health delivery systems is a tangled and complicated web, fraught with codicils and exceptions and secondary insurance, co-pays, co-conspirators, etc.  But why can't a normal human being understand what would seem to be a simple step. A surgeon's fee appears on a statement as $9200.  Medicare allows $1450, and pays $1135, leaving a balance of $815 to be paid by the patient, who hopefully has secondary insurance to pay another portion.  That's a simple process to understand, except the part where the initial billing is $9200.  I assume the doctor has to set a high number so that he will be reimbursed a sufficient amount to justify his expertise.  But why does that figure need to be so high?  Those who are setting the percentages know the actuality of it; no one is thinking that there is any chance that Medicare is going to reimburse the full amount, so why play with such an inflated stack of figures?  This is just one of an array of scenarios that I don't understand, and can only believe that
I could comprehend if I really wanted to, but it's not worth the effort.  Isn't the breakdown  of cognitive thought a symptom of senility?  Or do just the elderly make that connection, and don't bother to connect synapses.