Hospital Plan, necessary evil

I am about to have shoulder surgery and just found out that Fedhealth are only prepared to pay 30% of the total surgeons bill, in other words R13k out of R43k. Break it down further my annual subscription for the year is almost double what they will cover so in other words it would have been cheaper for me to pay cash and not have a hospital plan. I agree the surgeon obviously charges way above medical aid rates but are the medical aid rates not set too low and therefore surgeons charge way above. A good hospital plan is not cheap but they want to cover the least amount when you need them. So if you need surgery and you don't have additional funds for the difference, well then you will have to live with your pain because don't expect much help from your medical aids.