Rich is spot-on in both of his posts. I suspect that people who disagree either haven't been fleeced by a hospital yet due to their great health or are too rich to care. The hospitals would have you believe that they barely get by because of the deadbeats, regulations, and lawsuits but a peek into their financials reveals that many of them are making money hand over fist and could easily survive dramatic price reductions.
Patient care might be a doctor or a nurse's top priority but they aren't the ones setting the prices and the billing codes. They mark down the procedure and medications and someone else gets paid to code it up in a way that maximizes profit for the hospital. The hospital itself only cares about profit, even while claiming to be non-profit or to be doing God's work.
Thanks for reminding me that I should have made a distinction between my feelings about hospitals and my feelings about people in health-care. I love the people. I hate the hospitals. This goes back to the 1980s when I was an EMS volunteer and became familiar with the various abuses hospitals perpetrated in order to maximize their profits.
One of the most common abuses was bribery. The law and the protocols required us to transport patients to the closest suitable hospital if the patient / family / physician had no stated preference. The hospitals spent an inordinate amount of time and money wining and dining ambulance crews, trying to persuade us that they were the best (and therefore most "suitable") choices for every possible type of care.
It also was common knowledge that working in a management role for a big ambulance company, whether paid or volunteer, that did its own dispatching was the fastest route to a paid job working for the hospital, including many part-time, no-show, "consultant" positions.
Another common abuse was funneling patients who weren't acutely ill or injured through the ER when the walk-in clinic would have sufficed. These patients usually wound up in the ambulance because someone in authority decided that they should be seen "just to be on the safe side," and others were travelers who were unfamiliar with the area and didn't know who else to call for non-acute care.
One case in particular that I remember was someone from out-of-town who was on anti-rejection drugs, but was running low on her meds because of a prolonged blizzard. When she realized that she wouldn't be flying home for yet another day, she explained her situation to a gate agent at the airport. The gate agent called a cop, the cop called for an ambulance, and my unit got the call.
Now understand that this woman wasn't in any sort of trouble. She hadn't even run out of meds yet. She just needed a doc to write a scrip to cover the extra layover time. She even had the labeled pill bottle with her. But once a cop calls an ambulance, the ambulance has to transport; and once an ambulance pulls up to a hospital, the patient will be seen by the ER. I tried to bend the rules and drop her off at the hospital's walk-in clinic, but no-go. They refused to accept the hand-off even after we explained that all she needed was a scrip and that she was in no distress. It didn't matter. The only way they would accept the hand-off was at the ER.
We had many cases where people who didn't need to be seen at the ER were nonetheless forced into it, despite there being a more appropriate walk-in clinic available. Some examples included cyclists with scraped elbows from bicycle falls, elderly people who were confused about their medication dosages, and school kids with bumps and bruises from school yard fights. Once a cop, school nurse, social worker, or anyone else in authority decided that they should be seen, off to the ER they went.
And then there are those who don't need to be seen at all, such as uninjured travel companions of people injured in car wrecks. Often they ride along in the ambulance simply because they have no place else to go. But once they get to the hospital, unless they expressly and forcefully refuse it, they will be seen "just in case." A doctor will ask how they feel, they will say that they were uninjured and feel fine, the doctor will send them on their way, and a bill will be generated for tens of thousands of dollars in ER fees -- and that's assuming that no unnecessary lab work, x-rays, or specialist consultations are ordered to further pad the bill.
Oh, and by the way, even if the uninjured travel companion does expressly refuse treatment, they may
still get a bill for an "evaluation" by whomever they expressed their refusal to. Once the hospital knows your name, there's a pretty good chance that you're going to get a bill from the ER.
As a patient with a high-deductible insurance plan, I've also been frustrated trying to get prices from hospitals for even routine, non-emergency procedures. Try getting a straight answer from a hospital about the total cost of any procedure, including all the unnecessary horse**** that they tack on to pad the bill. Go ahead. Lotsa luck with that. State secrets should be so well guarded as hospital price lists.
And speaking of the unnecessary horse****, how about a hospital wanting an EKG, chest X-Ray, and CPE including > $400.00 worth of blood work prior to a routine colonoscopy, when all of the above had been done as part of my annual physical less than two weeks prior? How's that for padding a bill?
Or how about their demanding that their lab do the blood work rather than Quest, who would have done it for about $75.00 rather than > $400.00? And by the way, it took the hospital several days before they would even tell me how much the blood work would cost. It took Quest about eight seconds over the phone once I knew what tests the hospital wanted. But it didn't matter because the hospital wouldn't write the scrip for the blood work. It would have had to be done in their lab.
Or how about the hospital demanding that I pay for sedation and an anesthesiologist to supervise its administration even though I expressly didn't want sedation? What's that all about other than padding the bill?
Or how about their refusing to tell me how much a polypectomy and biopsy would cost if they were necessary? Those procedures aren't included in the fee for a diagnostic colonoscopy, which is supposedly "covered in full" with no deductibles, but actually isn't. But try to find out what they'll cost. Lotsa luck.
The complaints that hospital administrators have about all the costs associated with government requirements and indigent patients have some validity, I'm sure. But none of them explain why it's impossible to get a price quote from a hospital for a procedure that they do dozens of times every day.
Rich
Total moron.
Had to go through the same thing last year with two knee surgeries. Room charge? $2K per night (get a real nice suite in Vegas for that price). A single hydrocodone pill? $20 (get a full bottle with insurance for that cost). Hospitals charge every time the nurses wake you up in the middle of the night to ask how you feel and take your temp and BP to the tune of $250 per "visit". 
It's the "business" of medicine that costs all the money, not the "practice". MBA's should not be involved.