Greed plays a role in causing unnecessary surgery, although I don't think the economic motive alone is enough to explain it. There's no doubt that if you eliminated all unnecessary surgery, most surgeons would go out of business. They'd have to look for honest work, because the surgeon gets paid when he performs surgery on you, not when you're treated some other way. In pre-paid group practices where surgeons are paid a steady salary not tied to how many operations they perform, hysterectomies and tonsillectomies occur only about one-third as often as in fee-for-service situations.