All true. Over the past 10-12 years, the insurance industry in the USA, given new monopsony powers by the ACA, has set the terms of the insurer-provider relationship and consolidated service delivery, both to the detriment of the independent physician and low-level specialists like ultrasound techs or phlebotomists or TBI nurses. Private practitioners have largely retired, if they could afford to, or sold their practices and themselves to an umbrella group, with all the asset stripping and predation and performance-driven management that entails.

You’re comparing two different workers without the proper context, thus differences seem exaggerated. Sure there are going to be differences both material and cultural among different income levels for workers - but a doctor or coder or some other ‘white collar’ job has MUCH more in common with a welder or warehouse worker than either do with a billionaire. Again, it’s about how they relate to the means of production.

At the end of the day, both the suburban professional and the warehouse worker do not own the means of production. They are paid a wage or salary for providing their work, meaning their lives and material wealth depend upon them providing labor that somebody else profits off of. All of the ‘products’ are owned by the corporation or sole proprietor (rarer and rarer these days) which employs the worker, whether it be business to business tech solutions or manufacturing or medicine. So are all the tools for that matter. The worker ‘owns’ their labor, and that’s it. The exploitative relationship is present whether that worker is making 25k a year or 300k a year. Both are having their excess labor value ‘stolen’ by a capitalist class that does not actually take part in production, but instead leeches off of the workers under their employ.

Your incredulous attitude towards blue collar/white collar workers being in the same class is actually part of the problem, and a narrative that protects capital. It prevents workers from developing class consciousness and solidarity, thus the most direct beneficiaries get to keep their privileged position. Resentments are stoked such that private managerial class sorts feel an elitism to their class brothers who work less prestigious jobs. PMC’s are given more privileges and power than other workers, and it goes to their heads. Meanwhile the privilege of the PMC’s is used as both a carrot and a stick to prevent the more obviously exploited workers from questioning the system. Low wage workers are told, “see? You can do it too if only you WORK hard enough and develop the right SKILLS. You just have to COMPETE to prove your worth, and you too could have some cushy privileged job.” Of course, this ignores the fact that not everyone can have good jobs, and many of the" bad" jobs are only bad because of low pay/prestige, even though they’re VERY important (see essential workers).

The suburbs add to this divide, as it separates high wage workers from low wage workers both physically and culturally. The divide is naturally able to grow just from he lack of proximity, but it also allows high wage workers to develop a false solidarity with capitalists. Suddenly the high wage worker is living next to petty bougious business owners, executives from a local branch of a major corporation, and perhaps some actual capitalists like land lords or individuals who earn most of their income from “investments” instead of labor. They go to the same social events, their kids go to the same school, they live in relatively similar conditions, but at the end of the day the wealthy worker’s productivity and labor is bankrolling the lifestyle of the “investors” just the same as the low wage workers facing housing insecurity on the other side of town. The high wage worker is still at risk of “losing their job,” and it’s the executive/investor who gets to make that decision. The power differential is still there, even if obfuscated.