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Dr. Paul Caskey, chief of staff and orthopedic surgeon at Shriners Hospital for Children in Spokane, checks the range of movement in Samantha Viehouser’s back during a post-surgery checkup. Samantha has about $20,000 worth of titanium rods and screws in her back to correct scoliosis. Shriners Hospital is now billing insurance companies for the cost of the care. Samantha’s mother, Lynett, is at left.

Dan Pelle